{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:37:36Z","timestamp":1780108656904,"version":"3.54.0"},"reference-count":70,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The prevalence of advanced heart failure (AdHF) is increasing globally, driven by population aging and improved survival rates in chronic heart failure (CHF). Durable Mechanical Circulatory Support (DMCS), particularly Left Ventricular Assist Devices (LVADs), has become a cornerstone in AdHF management. However, its successful implantation requires a comprehensive preoperative evaluation integrating cardiac, hemodynamic, and systemic assessments. Echocardiography and cardiac magnetic resonance (CMR) provide critical data for risk stratification\u2014e.g., LV ejection fraction &lt; 25%, LV end-diastolic diameter &lt; 60 mm, or free wall RV longitudinal strain (fwRVLS) &gt; \u221214% predict poorer outcomes. Right heart catheterization (RHC) identifies hemodynamic contraindications (PVR &gt; 6 WU, PAPi &lt; 1.5, cardiac index &lt; 2 L\/min\/m2), while cardiopulmonary exercise testing (CPET) remains pivotal for assessing functional reserve (peak VO2 &lt; 12 mL\/kg\/min or &lt;50% predicted). Systemic assessment must address renal, hepatic, oncologic, and psychiatric comorbidities that influence surgical risk. Integrating these multimodal data within a multidisciplinary framework\u2014spanning cardiologists, cardiac surgeons, anesthesiologists, and psychologists\u2014optimizes selection and outcomes for DMCS candidates.<\/jats:p>","DOI":"10.3390\/diagnostics15222886","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:06:36Z","timestamp":1763111196000},"page":"2886","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multimodality Assessment for Durable Mechanical Circulatory Support Implantation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7596-2963","authenticated-orcid":false,"given":"Luca","family":"Martini","sequence":"first","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pagliaro","sequence":"additional","affiliation":[{"name":"Department of Heart-Chest-Vessels, Clinical-surgical Cardiology, AOU Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Maria","family":"Righini","sequence":"additional","affiliation":[{"name":"Department of Heart-Chest-Vessels, Clinical-surgical Cardiology, AOU Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-7407","authenticated-orcid":false,"given":"Massimo","family":"Mapelli","sequence":"additional","affiliation":[{"name":"Department of Critical and Rehabilitative Cardiology, Heart Failure and Clinical Cardiology, Centro Cardiologico Monzino, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9151-4335","authenticated-orcid":false,"given":"Cristina","family":"Madaudo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities (ProMISE), University of Palermo, 90129 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Ghionzoli","sequence":"additional","affiliation":[{"name":"Department of Heart-Chest-Vessels, Surgical Therapy of the Heart Failure and of the Heart Transplantation, AOU Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Sciaccaluga","sequence":"additional","affiliation":[{"name":"Department of Heart-Chest-Vessels, Surgical Therapy of the Heart Failure and of the Heart Transplantation, AOU Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bernazzali","sequence":"additional","affiliation":[{"name":"Department of Heart-Chest-Vessels, Surgical Therapy of the Heart Failure and of the Heart Transplantation, AOU Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Maccherini","sequence":"additional","affiliation":[{"name":"Department of Heart-Chest-Vessels, Surgical Therapy of the Heart Failure and of the Heart Transplantation, AOU Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serafina","family":"Valente","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy"},{"name":"Department of Heart-Chest-Vessels, Clinical-surgical Cardiology, AOU Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-3006","authenticated-orcid":false,"given":"Giulia Elena","family":"Mandoli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2297-7845","authenticated-orcid":false,"given":"Antonio Luca Maria","family":"Parlati","sequence":"additional","affiliation":[{"name":"Department of Critical and Rehabilitative Cardiology, Heart Failure and Clinical Cardiology, Centro Cardiologico Monzino, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3872-8964","authenticated-orcid":false,"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. 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