{
  "abstract": "Objectives\n\nRight ventricular failure remains a major cause of perioperative morbidity and early mortality after left ventricular assist device implantation. We evaluated whether a novel and readily available echocardiographic-hemodynamic surrogate of right ventricular pulmonary vascular coupling predicts right ventricular assist device requirement and survival after magnetically levitated centrifugal flow left ventricular assist device.Methods\n\nWe performed a multicenter retrospective study of 202 HeartMate 3 recipients with preoperative right ventricular dysfunction. The tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio was derived. The primary end point was assessing its capacity to prognosticate the right ventricular assist device need in comparison with other established indices of right ventricular dysfunction. Multivariable logistic regression, calibration analysis, bootstrap validation, cross-validation, incremental-value modeling, and sensitivity analyses excluding venoarterial extracorporeal membrane oxygenation and mechanically ventilated patients were performed. Survival was assessed using Kaplan-Meier and Cox analyses.Results\n\nThe tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio demonstrated strong discrimination for right ventricular assist device requirement and outperformed conventional predictors. Bootstrap validation confirmed model stability, and cross-validation demonstrated consistent discrimination. Sensitivity analysis showed that discrimination remained robust after excluding venoarterial extracorporeal membrane oxygenation and mechanically ventilated patients. Multivariable logistic regression showed that the tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio remained independently associated with overall 1-year survival age, body mass index, chronic kidney disease, and diabetes. Discrimination remained robust after excluding venoarterial extracorporeal membrane oxygenation and venoarterial extracorporeal membrane oxygenation placement before the left ventricular assist device. A tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio threshold of 0.9 was able to stratify patient survival at 30 days, 100 days, and 1 year after left ventricular assist device placement.Conclusions\n\nThe tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio improves prediction of right ventricular assist device requirement and survival after HeartMate 3 implantation and may enhance perioperative right ventricular risk stratification.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.",
    "Department of Cardiovascular Diseases and Cardiovascular Surgery, Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minn.",
    "Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.",
    "Department of Cardiothoracic Surgery, Baptist Health, Little Rock, Alaska."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ruben Crespo-Diaz"
    },
    {
      "affs": [
        1
      ],
      "name": "Katarzyna Hryniewicz"
    },
    {
      "affs": [
        1
      ],
      "name": "Benjamin Sun"
    },
    {
      "affs": [
        1
      ],
      "name": "Peter M Eckman"
    },
    {
      "affs": [
        1
      ],
      "name": "Michael Samara"
    },
    {
      "affs": [
        0
      ],
      "name": "Alfredo Clavell"
    },
    {
      "affs": [
        0
      ],
      "name": "Barry A Boilson"
    },
    {
      "affs": [
        2
      ],
      "name": "Mauricio A Villavicencio"
    },
    {
      "affs": [
        2
      ],
      "name": "Phillip J Spencer"
    },
    {
      "affs": [
        3
      ],
      "name": "Karol Mudy"
    },
    {
      "affs": [
        0
      ],
      "name": "Sudhir S Kushwaha"
    },
    {
      "affs": [
        0
      ],
      "name": "Lisa M Mielniczuk"
    },
    {
      "affs": [
        0
      ],
      "name": "Robert P Frantz"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fwj5jgx55v1yd.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.102045",
  "fulltext_url": "https://europepmc.org/articles/PMC13711174",
  "id": "fwj5jgx55v1yd",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948463",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Adult: Mechanical Circulatory Support"
    ],
    [
      "openalex",
      "2204|Mechanical Circulatory Support Devices"
    ]
  ],
  "openalex": "W7172413607",
  "pdf_url": "https://europepmc.org/articles/PMC13711174?pdf=render",
  "pmcid": "PMC13711174",
  "pmid": "42948463",
  "published": "2026-08-04",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/fwj5jgx55v1yd.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:36Z",
      "native_id": "MED:42948463",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948463"
    },
    {
      "first_seen": "2026-10-31T12:22:00Z",
      "native_id": "PMC13711174",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.102045"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Tricuspid annular plane systolic excursion/pulmonary vascular resistance index predicts right ventricular assist device requirement and mortality after magnetically levitated centrifugal-flow left ventricular assist device implantation.",
  "title_text": "Tricuspid annular plane systolic excursion/pulmonary vascular resistance index predicts right ventricular assist device requirement and mortality after magnetically levitated centrifugal-flow left ventricular assist device implantation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:00Z",
  "url": "https://research.draconitic.com/paper/fwj5jgx55v1yd",
  "venue": "JTCVS open",
  "versions": []
}