{"id":"028717bd92a4","type":"article","url":"https://hartvaat.nl/2021/08/01/echo-optimalisatie-van-lvad-en-functionele-capaciteit-gerandomiseerde-trial/","title":"Echo-optimalisatie van LVAD en functionele capaciteit: gerandomiseerde trial","title_en":"Effects of echo-optimization of left ventricular assist devices on functional capacity, a randomized controlled trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"ESC heart failure","doi":"10.1002/ehf2.13359","source_url":"https://doi.org/10.1002/ehf2.13359","authors":["Marzia Lilliu","Francesco Onorati","Giovanni Battista Luciani","Giuseppe Faggian"],"significance":5,"published":"2021-08-01","source_date":"2021-08-01","image":"","kennis":["https://hartvaat.nl/kennis/diagnostiek/inspanningstest-loopband-fiets/"],"congress":"","summary_en":"This randomized trial tested whether echo-guided optimization of LVAD pump parameters improves exercise capacity, evaluating individualized device programming for functional benefit in mechanically supported patients.","created":"2026-07-03T10:29:19Z","updated":"2026-07-03T13:28:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial naar het effect van echo-optimalisatie van LVAD-parameters op functionele capaciteit.","abstract_original":"AIMS: After the implantation of a left ventricular assist device (LVAD), many patients continue to experience exercise intolerance. VAFRACT trial evaluates the additional benefit of LVAD echo-guided optimization (EO) on functional capacity (FC), measured by cardiopulmonary exercise test (CPET), and quality of life (QoL). METHODS AND RESULTS: Twenty-seven patients were randomized in a 1:1 ratio to EO (EO group) vs. standard settings (CONTROL group) at least after 3 months from LVAD implant procedure. The optimal device speed was defined as the one that allows an intermittent aortic valve opening and a neutral position of the interventricular septum without increasing aortic or tricuspid regurgitation and preserving right ventricular function. The primary endpoint was peak oxygen uptake (VO2 peak) change after 3 months. Echo-guided optimization significantly improves VO2 peak (from 13.2 ± 2.5 to 14.2 ± 2.5 mL/kg/min; P < 0.001), oxygen pulse (from 9.75 ± 1.46 to 10.75 ± 2.2 mL; P < 0.001), CPET exercise time (from 490 ± 98 to 526 ± 116 s; P = 0.02), 6 min walk distance (from 363 ± 54 to 391 ± 52 m; P = 0.04), and QoL, using EuroQol Five Dimensions 3L (from 0.796 ± 0.1 to 0.85 ± 0.08; P < 0.001) and the Kansas City Cardiomyopathy Questionnaire (from 81.6 ± 6.9 to 84.6 ± 5.6; P = 0.025). CONCLUSIONS: Echo-guided optimization can significantly influence the FC and the QoL of LVAD patients. This procedure should represent a fundamental step in their clinical management, through the establishment of consolidated follow-up protocols. Our study may represent a starting point for a future, adequately powered clinical trial with a longer term follow-up."}