4.1 Imaging predictors of right ventricular failure after left ventricular assist device implantation
Echocardiographic parameters that have been studied as possible predictors of RVF can be broadly classified into two subgroups; those that represent geometric changes in the right ventricle (9,10) and those that reflect RV performance, hemodynamic changes, or both (8,11,12). A shortcoming of these parameters is that they usually do not fully reflect adaptive or maladaptive changes in the RV that occurs as heart failure progresses. Postoperative RVF has many causes, including but not limited to right ventricular volume overload, ventricular interdependence, high right ventricular afterload and inherent abnormalities in the right ventricular contractility (13). A single measurement that provides only one “dimension” of RV morphology or function could hardly predict occurrence of RVF in all patients when the causes of RVF differ among patients, which could also explain why singular echocardiographic measurements perform poorly when they are used in cohorts other than original derivation cohort.