Right ventricular systolic and diastolic function as assessed by speckle-tracking echocardiography improve with prolonged isolated left ventricular assist device support.

BACKGROUND: Right ventricular (RV) failure is a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Whether RV function deteriorates with prolonged LVAD support is unknown. Speckle-tracking echocardiography provides a sensitive, noninvasive, reproducible, and quantitative assessment of RV systolic and diastolic function.

METHODS: Echocardiograms were retrospectively reviewed from before and after implantation of a Heartmate II LVAD. Speckle-tracking analysis was performed to measure RV longitudinal systolic strain, strain rate, and diastolic strain rate for each patient at baseline and over discrete time periods after LVAD implantation.

RESULTS: Seventeen patients were included in the analysis, with an average follow-up after LVAD implantation of 234 ± 125 days. RV systolic strain improved in 15 patients, decreasing from -7.4 ± 2.3% to -9.7 ± 3.3% after LVAD (P = .026). Systolic strain rate improved in 11 patients, decreasing from -0.67 ± 0.25%/s to -0.96 ± 0.36%/s (P = .011). RV diastolic strain rate improved in 12 patients, increasing from 0.70 ± 0.33%/s to 1.02 ± 0.40%/s (P = .016).

CONCLUSIONS: Chronic LVAD support improves RV systolic and diastolic function in LVAD patients who did not require an RV assist device. Speckle-tracking echocardiography may offer a noninvasive technique for identifying and monitoring improvements in RV function in LVAD patients.