LMNA Mutations and Right Heart Failure in Patients With Cardiomyopathy and With Left Ventricular Assist Devices

Dilated cardiomyopathy (DCM) is a major cause of advanced heart failure requiring a left ventricular assist device (LVAD) or heart transplantation. Although implantation of an LVAD ameliorates end-organ dysfunction and improves exercise tolerance, right heart failure (RHF) after LVAD implantation remains a major unsolved problem. 1 Teuteberg JJ Cleveland Jr, JC Cowger J Higgins RS Goldstein DJ Keebler M et al. The Society of Thoracic Surgeons Intermacs 2019 Annual Report: the changing landscape of devices and indications. Ann Thorac Surg. 2020; 109: 649-660 Abstract Full Text Full Text PDF PubMed Scopus (255) Google Scholar The incidence of RHF in the late phase after LVAD implantation has been reported to be 8%–11% and is associated with poor prognoses. 2 Rich JD Gosev I Patel CB Joseph S Katz JN Eckman PM et al. The incidence, risk factors, and outcomes associated with late right-sided heart failure in patients supported with an axial-flow left ventricular assist device. J Heart Lung Transplant. 2017; 36: 50-58 Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar Therefore, it is important to predict the development of late RHF after LVAD implantation. We hypothesized that genetic factors are involved in the development of late RHF after LVAD implantation and examined whether Lamin A/C (LMNA) mutations, which cause DCM with a severe phenotype, 3 Hasselberg NE Haland TF Saberniak J Brekke PH Berge KE Leren TP et al. Lamin A/C cardiomyopathy: young onset, high penetrance, and frequent need for heart transplantation. Eur Heart J. 2018; 39: 853-860 Crossref PubMed Scopus (143) Google Scholar are associated with late RHF and poor prognosis after LVAD implantation.