Deep Y-Descent in Right Atrial Waveforms is Associated with RV Dysfunction and Worse Outcome in LVAD Patients

Abstract

Purpose Right atrial waveform provides diagnostic and clinical information in heart failure patients. Notably, the y-descent (Figure 1A) may provide information about right ventricular systolic and diastolic function. We aimed to investigate the clinical implication of right atrial waveform in LVAD patients. Methods Patients underwent right heart catheterization (RHC) at 6 months following LVAD implantation and were followed for 1 year afterwards. Impact of a deep y-descent (>3 mmHg) on echocardiographic RA and RV function and clinical outcomes were investigated. Results 56 LVAD patients (mean age 56.2 years, 77% male) underwent RHC. Patients with post-LVAD deep y-descent (N\u202f=\u202f22 [39%]) had increased right ventricular size and worse right ventricular function (Table 1A). The patients with deep y-descent had higher rates of GI bleeding (1.10 vs. 0.32 event/year), stroke (0.28 vs. 0.0 event/year), and heart failure readmissions (0.57 vs. 0.12 events/year) compared to those without (p Conclusion Deep y-descent of the right atrial waveform during LVAD support is associated with impaired right ventricular function and worse clinical outcomes.