{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:17:49Z","timestamp":1779167869990,"version":"3.51.4"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Durable left ventricular assist device (dLVAD) physiology predisposes to right heart failure (RHF) and aortic insufficiency (AI), recently labeled hemodynamic\u2010related events (HDREs). We sought to validate the recently proposed dLVAD Hemodynamic Classification System for HDREs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">RHF and AI HDREs were adjudicated, staged, and phenotyped on the basis of the Hemodynamic Classification System assessed at 6 months after dLVAD implantation. The primary outcome was a composite of HF hospitalization or cardiovascular death between 6 and 24\u2009months after dLVAD implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 183 qualifying consecutive patients with 6\u2010month assessments, RHF HDRE was adjudicated in all cases and AI HDRE in 161 (88.0%). Overall, 53 (29.0%) patients developed an RHF HDRE and 26 (16.0%) an AI HDRE (phenotypes: 39 isolated RHF, 15 isolated AI, 11 combined RHF\u2013AI, 3 not adjudicated). At pre\u2010dLVAD assessment, age and pulmonary artery pulsatility index were independently associated with RHF HDRE and pre\u2010dLVAD AI and systolic pulmonary artery pressure with AI HDRE. RHF HDRE (adjusted hazard ratio [HR], 2.69 [95% CI, 1.14\u20136.34];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.024), AI HDRE (adjusted HR, 4.21 [95% CI, 1.70\u201310.40];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002), and HDRE phenotypes (isolated RHF\/AI HDRE versus no HDRE: adjusted HR, 2.80 [95% CI, 1.03\u20137.62];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.044; combined RHF\/AI HDRE versus no HDRE: adjusted HR, 4.53 [95% CI, 1.33\u201315.35];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.015) were associated with the primary outcome. A graded increase in primary outcome was observed with increasing RHF and AI stages.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">We validated the dLVAD Hemodynamic Classification System for HDREs as a valuable tool to identify pathophysiological and clinical clusters of patients, linking it with significant prognostic implications. Its adoption may pave the way for targeted strategies aimed at mitigating HDREs and enhancing the long\u2010term success of dLVAD support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041475","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:15:36Z","timestamp":1761102936000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Validation of the Hemodynamic Classification System for Hemodynamic\u2010Related Events in Patients With Durable Left Ventricular Assist\u00a0Devices"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-6844","authenticated-orcid":false,"given":"Guglielmo","family":"Gallone","sequence":"first","affiliation":[{"name":"Harefield Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust","place":["London, United Kingdom"]},{"name":"Citt\u00e0 della Salute e della Scienza 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Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Maestro\u2010Benedicto","sequence":"additional","affiliation":[{"name":"Hospital de la Santa Creu i Sant Pau","place":["Barcelona, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Morley\u2010Smith","sequence":"additional","affiliation":[{"name":"Harefield Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust","place":["London, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2086-8718","authenticated-orcid":false,"given":"Maria Monteagudo","family":"Vela","sequence":"additional","affiliation":[{"name":"Harefield Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust","place":["London, United 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