677 PREDICTION OF RIGHT VENTRICULAR FAILURE AFTER LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION: ROLE OF VASODILATOR CHALLENGE

Abstract Pulmonary artery pulsatility index (PAPi) is an indicator of right ventricular (RV) function and independent predictor failure (RVF) following left assist device (LVAD) implantation. Administration vasodilator challenge during heart catheterization (RHC) could reduce RV workload allowing a better assessment its functional reserve. Patients undergoing LVAD implantation at our Institution between May 2013 August 2021 were enrolled. Only patients who had undergone RHC with sodium nitroprusside analyzed. We collected all available clinical, instrumental, haemodynamic parameters, baseline after infusion evaluated potential associations post-LVAD RVF. Of the 54 analyzed, 19 (35%) developed RVF Fractional area change (FAC) (OR: 0.647, CI: 0.481–0.871; P = 0.004), pulmonary systolic pressure (PASP)(OR: 0.856, 0.761–0.964; P=0.010), post-sodium (NTP) PAPi 0.218, 0.073–0.653; 0.006) predictors The model combining FAC, PASP, post-NTP demonstrated predictive accuracy 90.7%. Addition significantly increased European Registry for Mechanical Circulatory Support right-sided risk score [79.4 vs. 70.4%; under curve (AUC): 0.841 0.724, 0.022] CRITT (79.6% 74%; AUC: 0.861 0.767 0.033). Post-NTP has observed to be Dynamic using may represent method testing reserve in candidates Larger prospective studies are needed confirm this hypothesis.