Role for inflammatory markers in predicting right ventricular failure in mechanical assist device recipients

Right ventricular failure (RVF) is a common complication following left ventricular assist device (LVAD) implantation and increases patient morbidity and mortality. Due to the complex and limited understanding of RVF pathophysiology, efforts to prognosticate RVF after LVAD have been challenging. To fill the gaps, current efforts have been focused on identifying molecular drivers and physiological mechanisms of right ventricular dysfunction in this population. Recent work suggests that pro-inflammatory and oxidative stress pathways contribute to the development and progression of RVF post-LVAD, and elevation of inflammatory indices have been correlated with poor prognosis. Current prediction models are limited and performed only modestly in validation studies and do not include immunologic and molecular parameters, which could enhance pre-operative risk stratification towards reducing post-operative burden of RVF post-LVAD. In this review, we identified and summarized clinically relevant molecular and inflammatory markers of RVF and RVF following LVAD placement. Correlating these markers with current haemodynamic and echocardiographic parameters provides an avenue to reduce RVF after LVAD.