Heart failure & cardiomyopathiesSecondary analysis
Left Ventricular Dimensions and Clinical Outcomes With a Fully Magnetically Levitated Left Ventricular Assist Device
- Secondary analysis of the MOMENTUM 3 randomised trial portfolio
- multicentre
Authors' conclusion
Although infrequent in occurrence, smaller LVEDD (<55 mm) is associated with increased risk for early and late mortality, a consequence of hemocompatibility-related and right heart failure-related deaths.
Study context
- Population
- Patients with a HeartMate 3 LV assist device in the MOMENTUM 3 trial portfolio
- Participants
- 1,921 analyzable patients
- Comparison
- Left ventricular end-diastolic diameter (LVEDD) <55 mm vs LVEDD ≥55 mm
- LVEDD <55 mmn = 108
- LVEDD ≥55 mmn = 1,813reference
- Primary endpoint
- Overall survival and adverse events
- Follow-up
- 2 years
Primary result
Survival
Hazard ratio
1.97
95% CI 1.39–2.79
P = 0.0002
By group
LVEDD <55 mm vs LVEDD ≥55 mm
HR 1.97 (95% CI 1.39–2.79); P = 0.0002
As reported in the abstract
Further findings
Death during implant hospitalization
P = 0.0007
| Outcome | LVEDD <55 mm | LVEDD ≥55 mm | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Death due to hemocompatibility-related adverse events | 2.8% | 0.6% | 4.61 (1.29–16.45) | P = 0.018 | |
| 0.050.21520Hazard ratio (log scale) |
Safety
| Outcome | LVEDD <55 mm | LVEDD ≥55 mm | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Right HF, early (0-30 days) | 7.4% | 2.0% | 3.70 (1.73–7.91) | P = 0.001 | |
| Right HF, late (>30 days) | 12.0 % | 4.8% | 2.58 (1.37–4.84) | P = 0.003 | |
| Rehospitalization for low-flow alarms | 17.4 % | 8.3% | 2.39 (1.59–3.59) | P < 0.001 | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Left Ventricular Dimensions and Clinical Outcomes With a Fully Magnetically Levitated Left Ventricular Assist Device. JACC Heart Fail. Published 18 December 2024. doi:10.1016/j.jchf.2024.09.019
Summarised from the published abstract; every number is checked against it