Abstract 15965: Global Circumferential Strain Predicts Left Ventricular Recovery In Heart Failure Patients on Mechanical Circulatory Support
Background: Left ventricular assist devices (LVAD) can be utilized as destination therapy or a bridge to transplant. A subset of heart failure patients demonstrate left ventricular (LV) recovery and can be successfully explanted. However, the optimal means to determine LV recovery is unclear.
Methods: Our objective was to test the hypothesis that echocardiographic speckle tracking imaging can predict LV recovery in LVAD patients. We studied 32 heart failure patients with a LVAD, originally as a bridge to transplant. Echocardiography was performed on all patients 1–3 months after LVAD implantation at full LVAD flow and in approximately 50% of the patients at half or minimum flow (when tolerated). Speckle tracking global circumferential strain (GCS) was assessed from mid-LV short axis images. LV recovery was defined as: LV fractional area change (FAC) ≥ 35% and Echo Peak Pressure Index (EPPI) ≥ 35% .
Results: Overall, 27 patients (84%) had speckle tracking data. Their age was 47±13 yrs, 54% had ischemic disease. LV recovery occurred in 6 patients (22 %), and 21 patients were classified as LVAD dependent. A GCS cut-off of 7.4% was 80% sensitive and 86 % specific for predicting LV recovery in LVAD patients (AUC= 0.867, p = 0.0008). Fifteen patients (56 %) had pump flow reduced. LVAD dependent patients had a significantly lower GCS at full flow and reduced flow than LVAD recovered patients (p < 0.01). The GCS compared very well with FAC for predicting LV recovery (r=0.84 ,P <0.0001)
Conclusions: LV recovery may be identified in LVAD patients using speckle tracking strain imaging. GCS has the potential to improve prediction of LV recovery using a non invasive approach
- © 2010 by American Heart Association, Inc.