The Role of Right Ventricular Strain in Women and Men Following Left Ventricular Assist Device Implantation

Background Women and men have different perioperative hemodynamics, adverse event rates, and pump thrombosis-related mortality following left ventricular assist device (LVAD) implantation. However, gender differences in the subsequent development of right ventricular (RV) failure are not well defined. We evaluated the impact of gender on RV failure following LVAD implantation by speckle-tracking analysis of pre- and postoperative echocardiograms (echo). Methods Pre- and post-operative clinical, echo, and hemodynamic parameters were recorded in patients receiving LVADs from 2008-2018. Retrospectively, a subgroup of 74 women and 74 men were propensity score-matched 1:1 and chi square, t-tests, nonparametric tests, regression analysis, and Kaplan-Meier analysis were used to compare event rates. RV free-wall longitudinal strain (RV-FLS) and RV Fractional Area Change (RV-FAC) were calculated retrospectively using speckle-tracking, Tomtec Arena. All echo and RV strain measurements were blinded to gender outcomes. Results Preoperative hemodynamic parameters were not different between the two groups. However, women were more likely to have non-ischemic cardiomyopathy (81% vs 65%; p Conclusions RV strain analysis tracks standard hemodynamic and echo parameters and does not add to the assessment of RV function in women and men undergoing LVAD implantation.