Role of cardiac MRI in predicting the risk of right heart failure in patients who underwent left ventricular assist device implantation

Despite the advancement in the left ventricular assist devices (LVADs), right heart failure (RHF) remains a challenging adverse event after LVAD implantation and is associated with increased morbidity and mortality. In this study, we sought to assess the role of cardiac magnetic resonance-derived right ventricular ejection fraction (CMR-RVEF) in predicting the risk of post-LVAD RHF. Overall baseline characteristics and clinical outcomes were compared between the patients who developed post-LVAD RHF and those who did not. A total of 42 patients who underwent CMR before LVAD implantation were included in this study. The mean CMR-RVEF was 25 ± 13%, with no statistically significant difference between the 2 groups (27.7 ± 13.9% vs 24.5 ± 12.3, p = 0.5). The mean of the CMR-derived right ventricular volume index trend was higher in those with post-LVAD RHF (76 ± 28 ml/m2 vs 65 ± 25 ml/m2; p = 0.31). In conclusion, in patients who underwent CMR before LVAD implantation, CMR-RVEF may not predict post-LVAD RHF. Large multicenter studies are needed to confirm this finding.