Table 3

Candidate Echocardiographic Predictors of Post-LVAD RV Failure

ParameterRef. #sLimitations
PredictiveNot Predictive
RV fractional area change(63)(64,65,67–69)Poor reproducibility
Exaggerated by significant
TR and low PVR
RV/LV end-diastolic diameter ratio(66,67)(65,70)Standardization of views
TAPSE(64,68,69)(63,65–67,70)Sensitive to afterload
Less reliable if prior
cardiac surgery
Tissue DopplerDependent on transducer angle
Confounded by cardiac motion
and tethering
 Tricuspid S′(68,69)(67)
 Tricuspid e′(68)
RV strainLimited validation of
intervendor and
test-retest reliability
Requires adequate views
of RV free wall
 Global longitudinal(68)
 Free wall longitudinal(65)
 Global systolic strain rate(69)

E′ = early diastolic velocity of the tricuspid annulus; LV = left ventricular; LVAD = left ventricular assist device; PVR = pulmonary vascular resistance; RV = right ventricular; S′ = systolic velocity of the tricuspid annulus; TAPSE = tricuspid annular plane systolic excursion; TR = tricuspid regurgitation.