Table 3.
Univariable and Multivariable Predictors of Right Heart Failure
| Characteristic | Univariable model OR|95% CI|p-value | Liberal model OR|95% CI|p-value | Conservative model OR|95°% CI|p-value |
|---|---|---|---|
|
| |||
| Facility | |||
| MUSC | Reference | Reference | |
| Penn | (2.70)|0.888–8.21| p = 0.080 | (1.35)|.264–6.93| p = 0.716 | |
| Toronto | (0.24)|0.045–1.27| p = 0.093 | (.832)|.104–6.65| p = 0.863 | |
| Race | |||
| White | reference | ||
| Black | (1.60)|0.577–4.43| p = 0.367 | ||
| Hispanic | (2.09)|0.119–36.63| p = 0.614 | ||
| Asian | (0.00)|0.000–0.00| p = 1.00 | ||
| Other | (4.18)|0.341–51.24| p = 0.263 | ||
| Gender | |||
| Female | Reference | ||
| Male | (1.51)|0.461–4.96| p = 0.495 | ||
| Age | (0.999)|0.966–1.03| p = 0.951 | ||
| Device Type | |||
| HM3 | Reference | Reference | Reference |
| HM2 | (0.085)|0.010-.706| p = 0.023 | (0.095)|0.007–1.26| p = 0.074 | (0.081)|0.008–0.815| p = 0.033 |
| HVAD | (0.825)|0.244–2.79| p = 0.757 | Reference | Reference |
| Heart Failure Etiology | |||
| Non-Ischemic | reference | ||
| Ischemic | (0.738)|0.239–2.28| p = 0.597 | ||
| INTERMACS Profile | (0.514)|0.298–0.885| p = 0.016 | (0.745)|0.318–1.75| p = 0.499 | (0.707)|0.339–1.48| p = 0.356 |
| Temporary Mechanical Support at Implant | |||
| No | Reference | Reference | |
| Yes | (3.2)|.921–11.12| p = 0.067 | (1.03)|0.162–6.57| p = 0.972 | |
| Echo parameters | |||
| EDD LV (cm) | (1.15)|0.688 –1.91| p = 0.601 | ||
| LV Ejection Fraction (%) | (0.968)|0.897 – 1.04| p = 0.401 | ||
| TAPSE (mm) | (0.959)|0.872 –1.05| p = 0.384 | ||
| Severe RV Dysfunction | |||
| No | Reference | ||
| Yes | (0.761)|0.205–2.82| p = 0.683 | ||
| Severe RV Dilation | |||
| No | reference | ||
| Yes | (0.547)|0.132–2.27| p = 0.406 | ||
| Severe Mitral Regurgitation | |||
| No | reference | ||
| Yes | (2.07)|0.753–5.68| p = 0.159 | ||
| Severe Tricuspid Regurgitation | |||
| No | Reference | ||
| Yes | (0.240)|0.027 –2.12| p = 0.199 | ||
| Baseline Hemodynamics | |||
| MAP (mmHg) | (1.04)|0.982–1.10| p = 0.186 | ||
| PAPM (mmHg) | (1.08)|1.00–1.16| p = 0.051 | (1.12)|1.00–1.24| p = 0.049 | (1.12)|1.00–1.25| p = 0.046 |
| CI (L/min/m2) | (.738)|.187–2.91| p = 0.664 | ||
| RAP (mmHg) | (1.08)|.975–1.19| p = 0.143 | ||
| PAWP (mmHg) | (1.05)|.957–1.15| p = 0.301 | ||
| RAP:PAWP | (4.85)|0.380–61.89| p = 0.224 | ||
| PVR (Wood units) | (1.15)|0.911–1.44| p = 0.245 | ||
| SVI (mL/m2) | (0.882)|0.798–0.975| p = 0.014 | (1.07)|0.916–1.25| p = 0.397 | (1.06)|0.912–1.24| p = 0.436 |
| Pulmonary Ea (mmHg/mL)a | (2.61)|1.11–6.12| p = 0.028 | ||
| Pca (mL/mmHg) | (0.644)|0.254–1.64| p = 0.355 | ||
| PAPi (mmHg) | (0.863)|0.699–1.06| p = 0.167 | ||
| HR(BPM)a | (1.04)|1.01–1.07| p = 0.003 | ||
| Peak Hemodynamics | |||
| MAP (mmHg) | (1.05)|0.987–1.12| p = 0.126 | ||
| PAPM (mmHg) | (1.05)|0.977–1.14| p = 0.179 | ||
| CI (L/min/m2)a | (0.169)|0.049-.579| p = 0.005 | ||
| PAWP (mmHg) | (1.05)|0.972–1.14| p = 0.211 | ||
| PVR (Wood units) | (1.29)|0.909–1.83| p = 0.154 | ||
| SVI (mL/m2) | (0.864)|0.794-.939| p < 0.001 | (0.852)|0.756–0.959| p = 0.008 | (0.848)|0.754–0.955| p = 0.006 |
| Pulmonary Ea (mmHg/mL)a Risk Score | (9.05)|2.19–37.41| p = 0.002 | ||
| Penn Columbia Risk Score (Low Risk) | Reference | ||
| Penn Columbia Risk Score (Medium Risk) | (0.667)|0.196–2.27| p = 0.517 | ||
| Penn Columbia Risk Score (High Risk) | (1.60)|0.468–5.48| p = 0.454 | ||
| Euromacs RV Risk Score | (1.24)|0.952–1.61| p = 0.111 | ||
| Kormos RHF Risk Score | (1.20)|0.928–1.56| p = 0.164 | ||
| CRITT Score Lab Values | (1.47)|0.854–2.54| p = 0.164 | ||
| Lab Values | |||
| Hemoglobin (g/dL) | (0.952)|0.764–1.19| p=.666 | ||
| Sodium (mmol/L) | (0.953)|.862–1.05| p = 0.341 | ||
| Creatinine (mg/dL) | (1.88)|.838–4.23| p = 0.126 | ||
| Total Bilirubin (mg/dL) | (0.973)|0.704–1.34| p = 0.869 | ||
| Days Between RHC and LVAD implant | (0.990)|0.981–0.999| p = 0.033 | (0.999)|0.988–1.01| p = 0.815 | (0.998)|0.987–1.01| p = 0.719 |
Abbreviations: CI, cardiac index; Ea, effective arterial elastance; Exp(B), exponentiation of B coefficient; EDD, end-diastolic diameter; HM2, Heartmate 2; HM3, Heartmate 3; HR, heart rate; HVAD, Heartware Ventricular Assist Device; LV, left ventricle; LVAD, left ventricular assist device; MAP, mean arterial pressure; MCS, mechanical circulatory support; OR, odds ratio; PAPi, pulmonary arterial pulsatility index; PAPM, mean pulmonary artery pressure; PAWP, pulmonary arterial wedge pressure; Pca, pulmonary arterial compliance; Penn, University of Pennsylvania; PVR, pulmonary vascular resistance; RAP, right atrial pressure; RHC, right heart catheterization; RHF, right heart failure; RV, right ventricle; SVI, stroke volume index; TAPSE, tricuspid annular plane systolic excursion; Toronto, University of Toronto.
Liberal Model includes univariable covariates ≤ 0.10, Conservative model includes univariable covariates ≤ 0.05.
CI, Pulmonary Ea, HR, and SVI have significant collinearity so only SVI was included in the multivariable models.