Chicago Hemodynamics talk.11.13.25 v2.pptx

1、Hemodynamics of Recovery,Stavros G.Drakos,MD,PhDHA Edna Benning Professor of Medicine,2nd Annual Chicago Hemodynamic ForumNovember 14,2025,Role of Hemodynamics in assessing:RV Reserve and LV Reserve and Potential for Durable Myocardial Recovery,Multicenter Machine Learning Personalized Calculator To

2、 Assess Right Ventricular Reserve and Recovery Potential,n=1125 Advanced Therapies Candidates,Hemodynamic Predictors of RV Reserve and Failure,1.85,11.5 mmHg,0.59,0.57 mm Hg L1m2,22.5 mmHg,Morine K et al.J Card Fail 2016;22:110116Taleb I et al.JAMA Cardiology 2024;31:27282,Courtesy of Jon Grinstein,

3、In practise we saw that all these RV failure risk scores are good but not great in assessing RV Reserve-there is residual risk not adequately quantified,One of potential explanations:we evaluate RV function before LVAD or other interventions based on parameters such as Resting Hemodynamics,Echo,Bioc

4、hemistries that are inherently volatile,We tend to super-optimize these parameters in preparation for LVAD or other interventions/surgeries.,Following IABP+IV Milrinone OptimizationRA 10RV 46/8PA 46/23/30PCW 23Ao 122/68/90C.I.1.27PVR 2.9T-Bil 2.3,PAPi 1.54 RV strain-7.5%CVP/Wedge 0.45CVP 13 mmHg,PAP

5、i 2.30 RV strain-18.7%CVP/Wedge 0.42CVP 10 mmHg,Example of RV that we can make look better with optimization,BaselineRA 13RV 50/10PA 50/30/38PCW 29Ao 107/71/83C.I.1.05PVR 5.4T-Bil 4.2,Bonios/Drakos/Chamogeorgakis.ASAIO 2023,Is this example of volatile metrics that we“improved”with optimization?,How

6、Can We Better Assess the Reserve and Potential For Recovery,Assessment of RV Hemodynamic Reserve with Sodium Nitroprusside:Vasodilator Challenge/Pharmacological Unloading,Read/Azih/Hsu/Mak/Tedford.JHLT 2022,Peak stroke volume index(SVI)after nitroprusside independently associated with post-LVAD RV R