JHLT Open. 2025 Dec 30;11:100477. doi: 10.1016/j.jhlto.2025.100477. eCollection 2026 Feb.
ABSTRACT
BACKGROUND: Left ventricular assist device (LVAD) implantation is a life-saving therapy for end-stage heart failure, but right ventricular failure (RVF) remains a major complication. Current RVF risk models are limited. We hypothesized that pathogenic/likely pathogenic (P/LP) variants increase intrinsic RV vulnerability and post-LVAD RVF risk.
METHODS AND RESULTS: In a single-center retrospective study of 136 adults undergoing LVAD implantation in 2018-2024, 87% were male, 65% non-White, and 68% had non-ischemic cardiomyopathy. Genetic testing was completed in 48 (35%), identifying P/LP variants in 19%. Patients with P/LP variants had higher early RVF rates (89% vs. 38% vs. 15%, p<0.01) and longer hospitalizations (84 vs. 31 vs. 24 days, p=0.02) than those with variants of uncertain significance or negative results. Outcomes did not differ by ischemic versus non-ischemic etiology.
CONCLUSIONS: P/LP variants were associated with early RVF, suggesting that genetic testing may inform RVF risk stratification and perioperative management.
PMID:41630967 | PMC:PMC12860653 | DOI:10.1016/j.jhlto.2025.100477