Abstract 17141: Assessment of Dyssynchrony as an Indicator of Right Ventricular Free Wall Function by Gated Blood Pool SPECT (GBPS) in Patients undergoing LVAD Implantation
Introduction: RV function affects prognosis after LVAD, but is difficult to assess by conventional imaging due to complex geometry. Regional RV free wall (RVFW) function may be particularly important after LVAD due to septal shift toward the decompressed LV. We have previously shown feasibility of pre-LVAD GBPS (automated, count-based, without geometric assumptions) assessment of the RV, and the additive value of regional over global dysfunction. Here, we explored the utility of RVFW dyssynchrony assessment using phase analysis as a quantitative predictive parameter of RV regional function.
Methods: GBPS was performed using standard procedure on 25 patients awaiting LVAD. Global and regional RV function was assessed. The phase standard deviation (PSD) of the RVFW (non-septal portion of RV) was generated automatically. RV failure was defined as requiring RV assist device or requiring greater than 14 consecutive days of postoperative inotropic support after LVAD implant.
Results: Of 25 consecutive patients studied (mean age 57 years, 84% male, 76% white), 16 (64 %) had regional dysfunction involving the RVFW; and had higher PSD (61.1 ± 31.7 ms vs. 37.9 ± 13.4 ms, p=0.048). ROC analysis was used to determine a PSD cut off with the greatest ability to discriminate patients who had RV failure and yielded a value of 60 ms.
Conclusions: Heart failure patients with RVFW dyssynchrony are more likely to develop RV failure after LVAD implantation. To our knowledge, this is the first study that examines RVFW dyssynchrony in this setting.
Author Disclosures: A. Nayak: None. C.B. Link: None. A.D. Althouse: None. R. Kormos: None. M.A. Simon: None. J. Teuteberg: Speakers Bureau; Modest; HeartWare, CareDx. Consultant/Advisory Board; Modest; HeartWare, Abiomed, CareDx, Acorda Therapeutics. Other; Modest; Thoratec. L. Lagazzi: None. P. Soman: None.
- © 2016 by American Heart Association, Inc.