dPmax for Predicting Right Ventricular Failure After Left Ventricular Assist Device Implantation

This single-center, prospective observational study aims to evaluate whether dPmax, a measure of the maximum rate of arterial pressure rise obtained through pulse contour analysis, can predict right ventricular failure after left ventricular assist device (LVAD) implantation in adults. Measurements collected during routine monitoring before and after anesthesia induction will be analyzed alongside preoperative echocardiographic findings. The primary outcome is right ventricular failure within 30 days after surgery, assessed using Mechanical Circulatory Support-Academic Research Consortium (MCS-ARC) criteria. Secondary objectives include comparing the predictive performance of dPmax with the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/SPAP) and identifying an optimal dPmax threshold for predicting right ventricular failure. No additional invasive procedures will be performed for research purposes.

Inclusion Criteria: * Age 18 years or older. * Scheduled for left ventricular assist device (LVAD) implantation. * Availability of the clinical data required for the study. * Willingness and ability to provide informed consent. Exclusion Criteria: * Congenital heart disease associated with transposition of the great arteries. * Ongoing extracorporeal membrane oxygenation (ECMO) or extracorporeal ventricular assist device (ExVAD) support immediately before LVAD implantation. * Severe aortic regurgitation, severe peripheral arterial disease, or refractory and uncontrolled tachyarrhythmia that may interfere with arterial waveform analysis. * Unwillingness to participate or cognitive impairment preventing informed consent.