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.