Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation
Abstract Aims 20% to 40% of left ventricular assist device (LVAD) device implantations are complicated by right ventricular (RV) failure that results in significant morbidity and mortality. We hypothesized that the duration on milrinone infusion is an independent risk factor for RV failure following...
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doaj-53c6d7e2345e4f95a8f452e78e4b727d2021-02-09T07:26:00ZengWileyESC Heart Failure2055-58222020-08-01741949195510.1002/ehf2.12791Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantationMina M. Benjamin0Sakthi Sundararajan1Samian Sulaiman2Bryan Miles3Rebekah J. Walker4Lucian Durham5Takushi Kohmoto6David L. Joyce7David Ishizawar8Nunzio Gaglianello9Asim Mohammed10Division of General Internal Medicine Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of General Internal Medicine Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of General Internal Medicine Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of General Internal Medicine Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USACenter for Advancing Population Science Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of Cardiothoracic Surgery Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of Cardiothoracic Surgery Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of Cardiothoracic Surgery Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of Cardiovascular Medicine Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of Cardiovascular Medicine Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USADivision of Cardiovascular Medicine Froedtert & The Medical College of Wisconsin 9200 West Wisconsin Avenue Milwaukee WI 53226‐3596 USAAbstract Aims 20% to 40% of left ventricular assist device (LVAD) device implantations are complicated by right ventricular (RV) failure that results in significant morbidity and mortality. We hypothesized that the duration on milrinone infusion is an independent risk factor for RV failure following LVAD implantation. Methods and results Retrospective demographic, clinical and hemodynamic data were collected on all adults with ACC/AHA stage D heart failure on intravenous milrinone who underwent LVAD implantation between 2012 and 2019. Patients (n = 104) were divided into two groups, those on milrinone <30 days (STM, n = 55) vs. ≥30 (LTM, n = 49). The primary endpoint was the prevalence of RV failure (need for inotropic support for more than 14 days or RV assist device) within 30 days post‐LVAD implantation. There were no significant differences between STM and LTM patients with respect to demographic, echocardiographic, right heart catheterization data, or baseline medications. The mean age of patients was 55.6 ± 12 years (70% male patients). Mean duration on milrinone was 13.7 vs. 81.0 days in STM and LTM, respectively. Forty‐five (43.3%) patients developed RV failure. LTM had higher prevalence of RV failure with odds ratio (OR) = 5.04 (95% CI 2.18–11.68, P = 0.0002). After adjusting for age, gender, and co‐morbidity count, the OR was 6.33 (95% CI 2.51–15.93), P < 0.0001. Conclusions In this retrospective study of ACC/AHA stage D HF patients, longer duration of milrinone infusion was associated with higher prevalence of RV failure after LVAD implantation.https://doi.org/10.1002/ehf2.12791Heart failureLeft ventricular assist deviceMilrinoneInotropesRight ventricular failure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mina M. Benjamin Sakthi Sundararajan Samian Sulaiman Bryan Miles Rebekah J. Walker Lucian Durham Takushi Kohmoto David L. Joyce David Ishizawar Nunzio Gaglianello Asim Mohammed |
spellingShingle |
Mina M. Benjamin Sakthi Sundararajan Samian Sulaiman Bryan Miles Rebekah J. Walker Lucian Durham Takushi Kohmoto David L. Joyce David Ishizawar Nunzio Gaglianello Asim Mohammed Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation ESC Heart Failure Heart failure Left ventricular assist device Milrinone Inotropes Right ventricular failure |
author_facet |
Mina M. Benjamin Sakthi Sundararajan Samian Sulaiman Bryan Miles Rebekah J. Walker Lucian Durham Takushi Kohmoto David L. Joyce David Ishizawar Nunzio Gaglianello Asim Mohammed |
author_sort |
Mina M. Benjamin |
title |
Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation |
title_short |
Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation |
title_full |
Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation |
title_fullStr |
Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation |
title_full_unstemmed |
Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation |
title_sort |
association of preoperative duration of inotropy on prevalence of right ventricular failure following lvad implantation |
publisher |
Wiley |
series |
ESC Heart Failure |
issn |
2055-5822 |
publishDate |
2020-08-01 |
description |
Abstract Aims 20% to 40% of left ventricular assist device (LVAD) device implantations are complicated by right ventricular (RV) failure that results in significant morbidity and mortality. We hypothesized that the duration on milrinone infusion is an independent risk factor for RV failure following LVAD implantation. Methods and results Retrospective demographic, clinical and hemodynamic data were collected on all adults with ACC/AHA stage D heart failure on intravenous milrinone who underwent LVAD implantation between 2012 and 2019. Patients (n = 104) were divided into two groups, those on milrinone <30 days (STM, n = 55) vs. ≥30 (LTM, n = 49). The primary endpoint was the prevalence of RV failure (need for inotropic support for more than 14 days or RV assist device) within 30 days post‐LVAD implantation. There were no significant differences between STM and LTM patients with respect to demographic, echocardiographic, right heart catheterization data, or baseline medications. The mean age of patients was 55.6 ± 12 years (70% male patients). Mean duration on milrinone was 13.7 vs. 81.0 days in STM and LTM, respectively. Forty‐five (43.3%) patients developed RV failure. LTM had higher prevalence of RV failure with odds ratio (OR) = 5.04 (95% CI 2.18–11.68, P = 0.0002). After adjusting for age, gender, and co‐morbidity count, the OR was 6.33 (95% CI 2.51–15.93), P < 0.0001. Conclusions In this retrospective study of ACC/AHA stage D HF patients, longer duration of milrinone infusion was associated with higher prevalence of RV failure after LVAD implantation. |
topic |
Heart failure Left ventricular assist device Milrinone Inotropes Right ventricular failure |
url |
https://doi.org/10.1002/ehf2.12791 |
work_keys_str_mv |
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