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Pressure-dimension index: A novel “morphologic-functional” index of right ventricle that predicts short-term survival after left ventricular assist device implantation
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  • Koray Kalenderoğlu,
  • Tolga Guvenc,
  • Semra Agustos,
  • Yalçın Velibey,
  • Muge Tasdemir Mete,
  • Huseyin Kuplay,
  • Rengin Çetin Güvenç,
  • Serap Aykut Aka
Koray Kalenderoğlu
Bayrampasa Training and Research Hospital
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Tolga Guvenc
Kirklareli Universitesi
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Semra Agustos
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi
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Yalçın Velibey
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi
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Muge Tasdemir Mete
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi
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Huseyin Kuplay
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi
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Rengin Çetin Güvenç
Kirklareli Universitesi
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Serap Aykut Aka
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi
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Abstract

Background: Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is a major cause of postoperative morbidity and mortality. Despite the availability of multiple imaging parameters, none of these parameters had adequate predictive accuracy for post-LVAD RVF. Aim: To study whether right ventricular pressure-dimension index (PDI), which is a novel echocardiographic index that combines both morphologic and functional aspects of the right ventricle, is predictive of post-LVAD RVF and survival. Methods: 49 cases that underwent elective LVAD implantation were retrospectively analyzed using data from an institutional registry. PDI was calculated by dividing systolic pulmonary artery pressure to the square of the right ventricular minor diameter. Cases were categorized according to tertiles. Results: Patients within the highest PDI tertile (PDI>3.62 mmHg/cm2) had significantly higher short-term mortality (42.8%) and combined short-term mortality and definitive RVF (50%) compared to other tertiles (p<0.05 for both, log-rank p for survival to 15th day 0.014), but mortality was similar across tertiles in the long-term follow up. PDI was an independent predictor of short-term mortality (HR:1.05–26.49, p=0.031) and short-term composite of mortality and definitive RVF (HR:1.37–38.87, p=0.027). Conclusions: Increased PDI is a marker of an overburdened right ventricle. Heart failure patients with a high PDI is at risk for short-term mortality following LVAD implantation.

Peer review status:ACCEPTED

02 Oct 2020Submitted to Echocardiography
05 Oct 2020Submission Checks Completed
05 Oct 2020Assigned to Editor
06 Oct 2020Reviewer(s) Assigned
08 Feb 2021Review(s) Completed, Editorial Evaluation Pending
08 Feb 2021Editorial Decision: Revise Major
16 Mar 20211st Revision Received
16 Mar 2021Assigned to Editor
16 Mar 2021Submission Checks Completed
19 Mar 2021Reviewer(s) Assigned
29 Mar 2021Review(s) Completed, Editorial Evaluation Pending
04 Apr 2021Editorial Decision: Revise Minor
11 Apr 20212nd Revision Received
12 Apr 2021Submission Checks Completed
12 Apr 2021Assigned to Editor
12 Apr 2021Reviewer(s) Assigned
14 Apr 2021Review(s) Completed, Editorial Evaluation Pending
26 Apr 2021Editorial Decision: Accept