Heart failure & cardiomyopathies
Association Between Pulmonary Artery Pulsatility and Mortality After Implantation of Left Ventricular Assist Device
Authors' conclusion
Preoperative PAPi < 2.84 was associated with a higher risk of early mortality after LVAD implantation without impacting 2 year outcomes among survivors.
Study context
- Population
- Patients undergoing left ventricular assist device (LVAD) implantation, 2007–2021
- Participants
- 117 patients
- Exposure
- Preoperative Pulmonary Artery Pulsatility Index (PAPi) ≥ 2.84 vs PAPi < 2.84
- Outcome
- Survival according to ROC-derived PAPi threshold
- Follow-up
- 3 months
Methodological detailsmulticentre registry (ASSIST-ICD)
- Multicentre registry (ASSIST-ICD)
Main finding
Survival
Hazard ratio
0.08
CI 0.02–0.28
P < 0.01
By group
PAPi ≥ 2.84vs PAPi < 2.84
HR 0.08 (CI 0.02–0.28); P < 0.01
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| Survival after 3 months | 0.67 (0.17–2.67) | P = 0.57 | |
| 0.10.31310Hazard ratio (log scale) |
Predictors of 2-year mortality (multivariate analysis)
- Systemic hypertension, HR [CI], P < 0.01
- 4.22 [1.49-11.97]
- DM, HR [CI], P < 0.01
- 4.90 [1.83-13.14]
- LVAD as bridge to transplant (higher 2-year survival), HR [CI], P = 0.02
- 0.18 [0.04-0.74]
- Heart transplantation (higher 2-year survival), HR [CI], P < 0.01
- 0.02 [0.00-0.18]
Preoperative PAPi, whole study population
- Median PAPi [IQR 1.63-4.69]
- 2.83
- ROC-determined PAPi threshold
- 2.84
Safety
- Postoperative RV failure, whole population (n, %)
- 57 (48.7%)
- No significant difference between survivors and non-survivors at 1 month, OR (P = 0.30)
- 1.59
Original publication
Association Between Pulmonary Artery Pulsatility and Mortality After Implantation of Left Ventricular Assist Device. ESC Heart Fail. Published 5 April 2024. doi:10.
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