Right Heart Function Worsens in LVAD Patients with Decoupling between Pulmonary Artery and Wedge Pressures

Purpose Decoupling between diastolic pulmonary artery pressure (dPAP) and pulmonary capillary wedge pressure (PCWP) is an index of pulmonary vascular damage and is associated with recurrence of heart failure during LVAD support. This study aimed to investigate the impact of decoupling on right heart function. Methods In this prospective study, LVAD patients underwent invasive hemodynamic testing. Decoupling was defined as >5 mmHg of difference between dPAP and PCWP. We compared right heart function between those with and without decoupling, as assessed by transthoracic echocardiography at the time of catheterization and one year later. Results 69 patients (mean age 61 years, 49% male) were enrolled. 33 patients (48%) had decoupling. At baseline, all investigated right heart parameters were worse in the decoupling group (p Conclusion Presence of decoupling has a negative impact on right heart function during LVAD support. Therapeutic strategies to address decoupling may reduce right heart failure post-LVAD.