Hemodynamic Related Events Addressing RV Failure and Aortic Insufficiency.pptx

1、Hemodynamic Related Events(HDREs):,Addressing RV Failure and Aortic Insufficiency,Farooq Sheikh,MD,FACCMedical Director,Advanced Heart Failure Program,Boulet J,Nayak A,Mehra MR,J Card Fail.2022 Dec;28(12):1738-1740.Grinstein J et al.,J Am Coll Cardiol 2023;82:7081.Saeed D et al.,J Heart Lung Transpl

2、ant 2024;43:18811893.,An Imperative:Addressing Residual Risk with LVAD Therapy,Grinstein J et al.,J Am Coll Cardiol 2023;82:7081.*Mehra MR et al.,N Engl J Med.2018;378(15):13861395.*Uriel N et al.,Eur J Heart Fail.2023;25(2):286294.+Mehra MR et al.,JAMA.2022 Sep 27;328(12):1233-1242.+Holley CT et al

3、.,J Heart Lung Transplant.2017;36(1):9196.,Assessing the Impact of HF in LVAD Recipients,Vidula H et al.,J Am Coll Cardiol HF 2022;10:470481.Nayak A et al.,J Am Coll Cardiol 2023;82:771781.,Hemodynamic Classification System:Definitions and Validation,Grinstein J et al.Circ Heart Fail.2023;16:e010713

4、.Gallone G et al.,J Am Heart Assoc.2025;14:e041475.,RHF and AI HDREs adjudicated 6 months after LVAD implantation.Primary outcome:composite of HF hospitalization or CV death 6-24 months.,Hemodynamic(HDRE)Classification System Validation,Gallone G et al.,J Am Heart Assoc.2025;14:e041475.,Relationship

5、 between RV Functional Reserve and AoV function,Closed AV group:lower RVSWI and RV dP/dt max(no difference in PAWP and PVR).RVSWI was independently associated with AV openingThe incidence of adverse events was higher in closed AV group(median follow up 743 days),Takenaka S et al.,J Heart Lung Transp

6、lant 2025;44:17761785,The Impact of LVAS Implantation on RV Function,Alterations in anatomy and physiology,place an already“stressed”RV at greater risk,Houston BA et al.,J Heart LungTransplant 2017;36:701707.,PrePost,RHF:Prevalence and Outcomes(STS-Intermacs),Kapelios CJ et al.,Circ Heart Fail.2022;