Data Supplement
Supplemental Results
We performed a separate analysis focused on the patients that completed 6 months of LVAD support, excluding the
patients with shorter duration of support that could have been considered inadequate to attest the full effects of
mechanical unloading. As shown in Supplemental Figure 1 and Supplemental Figure 2 the ‘relative increase’ in left
ventricular ejection fraction (LVEF) and the ‘higher LVEF achieved’ for this subgroup of patients were comparable to the
corresponding results on the whole study population (as shown in Figures 2 and 3).
Supplemental Figure Legends
Supplemental Figure 1. Relative increase in left ventricular ejection fraction (LVEF) defined as ‘pre-LVAD to highest
LVEF achieved post-LVAD’ in patients that completed 6 months of mechanical unloading. Data is presented as
percentages, means and confidence intervals, *p<0.01 vs. Pre LVAD; †p<0.05 vs. Pre LVAD.
Supplemental Figure 2. Highest left ventricular ejection fraction (LVEF) achieved in patients that completed 6 months of
mechanical unloading. Data is presented as percentages, means and confidence intervals, *p<0.01 vs. Pre LVAD;
†p<0.05 vs. Pre LVAD.
Supplemental Tables
Table 1. Left Ventricular Structure and Systolic Function Under Increased Loading Conditions During LVAD Speed Turn-down Echocardiographic Study (n=38)
30 days
Parameter
LVEDDI,
cm/m2
LVESDI,
cm/m2
IVSd,
cm
IVSs,
cm
PWd,
cm
PWs,
cm
LVEDVI,
ml/m2
LVESVI,
ml/m2
LVEF,
%
Sm (s),
cm/s
Sm (l),
cm/s
Pre-TD
2.8 [2.4,
3.4]
2.6 [2.0,
3.3]
0.9 [0.8,
1.2]
1.1 [1.0,
1.4]
0.9 [0.8,
1.1]
1.1 [0.9,
1.3]
84 [66,
119]
66 [46,
102]
23 [15,
28]
0.05
[0.04,
0.06]
0.06
[0.04,
0.08]
Post-TD
2.9 [2.4,
3.4]
2.6 [2.1,
3.0]
1.0 [0.8,
1.2]
1.1 [0.9,
1.4]
0.9 [0.8,
1.1]
1.0 [0.9,
1.2]
94 [65,
121]
74 [53,
100]
22 [15,
35]*
0.05
[0.04,
0.07]
0.06
[0.04,
0.08]
60 days
Pre-TD
2.8 [2.3,
3.0]
2.6 [1.9,
2.9]
0.9 [0.8,
1.1]
1.0 [0.9,
1.2]
0.9 [0.8,
1.0]
1.0 [0.9,
1.2]
70 [57,
90]
53 [36,
66]
26 [17,
30]
0.06
[0.05,
0.07]
0.06
[0.06,
0.08]
Post-TD
2.8 [2.2,
3.2]
2.6 [2.0,
3.0]
0.9 [0.7,
1.0]
1.1 [1.0,
1.3]
0.9 [0.7,
0.9]
1.1 [0.9,
1.2]
78 [58,
91]
55 [46,
68]
26 [15,
34]
0.06
[0.05,
0.06]
0.07
[0.06,
0.08]
90 days
Pre-TD
2.9 [2.3,
3.4]
2.5 [2.0,
3.1]
0.9 [0.8,
1.0]
1.1 [0.9,
1.3]
0.8 [0.7,
1.0]
1.1 [0.9,
1.2]
91 [61,
131]
74 [44,
113]
20 [14,
29]
0.04
[0.04,
0.07]
0.06
[0.04,
0.07]
Post-TD
3.0 [2.2,
3.5]
2.6 [2.0,
3.1]
0.9 [0.8,
1.2]
1.0 [0.9,
1.2]
0.8 [0.7,
1.0]
1.0 [0.9,
1.2]
105 [68,
146]
86 [46,
120]
20 [14,
30]
0.04
[0.03,
0.06]
0.06
[0.03,
0.07]
120 days
Pre-TD
2.7 [2.2,
3.5]
2.2 [1.5,
2.9]
1.0 [0.9,
1.3]
1.2 [1.1,
1.4]
0.8 [0.8,
1.0]
1.2 [1.0,
1.3]
62 [50,
121]
46 [32,
99]
25 [15,
38]
0.05
[0.04,
0.07]
0.07
[0.05,
0.07]
Post-TD
2.7 [2.3,
3.5]
2.4 [2.0,
2.9]
1.1 [0.9,
1.2]
1.2 [1.0,
1.4]
1.0 [0.8,
1.1]
1.1 [1.0,
1.2]
75 [46,
142]
50 [32,
114]
30 [17,
36]
0.05
[0.04,
0.05]
0.05
[0.05,
0.05]
180 days
Pre-TD
2.3 [2.1,
3.1]
1.8 [1.7,
2.8]
1.0 [0.9,
1.0]
1.2 [1.1,
1.2]
1.0 [0.9,
1.1]
1.1 [1.0,
1.2]
45 [30,
88]
29 [12,
71]
33 [28,
50]
0.06
[0.06,
0.08]
0.06
[0.05,
0.10]
Post-TD
2.4 [2.3,
3.1]
1.8 [1.7,
2.4]
0.8 [0.8,
1.0]*
1.0 [0.9,
1.3]
0.9 [0.8,
0.9]*
1.2 [0.9,
1.4]
65 [34,
98]*
42 [15,
67]
35 [29,
50]
0.06
[0.06,
0.07]
0.06
[0.05,
0.08]
270 days
Pre-TD
2.4 [2.1,
2.7]
2.0 [1.9,
2.7]
1.0 [0.7,
1.3]
1.2 [0.8,
1.4]
0.9 [0.7,
1.1]
1.0 [0.7,
1.2]
52 [44,
65]
39 [28,
43]
22 [19,
38]
0.05
[0.05,
0.06]
0.05
[0.03,
0.08]
Post-TD
2.3 [2.0,
2.8]
2.0 [1.8,
2.2]
1.1 [0.7,
1.2]
1.2 [0.9,
1.2]
0.8 [0.6,
0.9]
1.0 [0.8,
1.2]
59 [45,
74]
34 [30,
49]
25 [18,
41]
0.05
[0.05,
0.06]
0.05
[0.03,
0.06]
365 days
Pre-TD
2.6 [2.0,
2.7]
2.3 [1.6,
2.4]
0.8 [0.6,
1.0]
0.9 [0.7,
1.1]
0.8 [0.7,
0.8]
0.9 [0.8,
1.1]
60 [44,
87]
40 [31,
64]
25 [22,
31]
0.07
[0.05,
0.10]
0.08
[0.06,
0.10]
Post-TD
2.8 [2.4,
2.9]
2.5 [2.0,
2.7]
0.8 [0.6,
1.0]
0.9 [0.8,
1.2]*
0.7 [0.6,
0.8]
0.9 [0.8,
1.0]
72 [58,
91]*
51 [48,
64]*
27 [17,
36]
0.08
[0.05,
0.08]
0.06
[0.05,
0.08]*
IVSd= interventricular septum dimension at end-diastole; IVSs= interventricular septum dimension at end-systole; LVEDDI=left
ventricular end-diastolic dimension index; LVEDVI=left ventricular end-diastolic volume index; LVEF=left ventricular ejection fraction;
LVESDI=left ventricular end-systolic dimension index; LVESVI=left ventricular end-systolic volume index; PWd=posterior wall
dimension at end-diastole; PWs=posterior wall dimension at end-systole; Sm=systolic motion of the mitral annulus at the (s) septal
and (l) lateral positions; TD= LVAD speed turndown. Values are expressed as median [25th, 75th percentiles], *p<0.05 vs. pre-TD.
Table 2. Left Ventricular Diastolic Function Under Increased Loading Conditions During LVAD Speed Turn-down Echocardiographic Study (n=38)
30 days
60 days
90 days
120 days
180 days
270 days
365 days
Parameter
LADI,
cm/m2
LASVI,
ml/m2
E wave,
cm/s
a wave,
cm/s
DT,
ms
E’ (s),
cm/s
E’ (l),
cm/s
Pre-TD
Post-TD
Pre-TD
Post-TD
Pre-TD
Post-TD
Pre-TD
Post-TD
Pre-TD
Post-TD
Pre-TD
Post-TD
Pre-TD
Post-TD
2.1
[1.9,
2.4]
30 [24,
38]
0.8
[0.6,
0.9]
0.4
[0.3,
0.7]
192
[137,
240]
0.06
[0.05,
0.07]
0.08
[0.07,
0.12]
2.0
[1.8,
2.4]
37 [24,
46]
0.8
[0.6,
1.0]
0.5
[0.3,
0.7]
200
[135,
236]
0.06
[0.05,
0.08]
0.08
[0.06,
0.12]
1.9
[1.7,
2.3]
28 [19,
33]
0.8
[0.8,
1.0]
0.5
[0.4,
0.6]
192
[161,
260]
0.08
[0.04,
0.1]
0.11
[0.10,
0.12]
2.1
[1.8,
2.3]
28 [21,
32]
0.8
[0.7,
1.0]
0.5
[0.4,
0.7]
175
[160,
210]
0.07
[0.04,
0.08]
0.11
[0.09,
0.13]
2.1
[1.8,
2.3]
31 [21,
41]
0.8
[0.8,
1.0]
0.5
[0.3,
0.8]
180
[142,
205]
0.07
[0.06,
0.09]
0.08
[0.06,
0.12]
2.2
[1.9,
2.4]
33 [22,
41]
0.8
[0.8,
1.0]
0.6
[0.3,
0.8]
165
[130,
192]*
0.07
[0.04,
0.10]
0.08
[0.06,
0.09]
2.1
[1.7,
2.5]
32 [25,
42]
0.8
[0.6,
1.1]
0.6
[0.4,
0.7]
210
[180,
230]
0.07
[0.05,
0.08]
0.09
[0.08,
0.09]
2.0
[1.8,
2.3]
35 [30,
42]
0.8
[0.6,
1.2]
0.5
[0.3,
0.6]
190
[150,
210]
0.06
[0.05,
0.07]
0.07
[0.05,
0.09]
2.1
[1.7,
2.5]
21 [16,
32]
1.0
[0.6,
1.2]
0.4
[0.4,
0.6]
194
[160,
206]
0.09
[0.07,
0.10]
0.12
[0.08,
0.14]
1.9
[1.7,
2.4]
27 [15,
36]
1.0
[0.6,
1.2]
0.5
[0.4,
0.7]
184
[121,
220]
0.07
[0.06,
0.10]
0.11
[0.08,
0.12]
2.0
[1.8,
2.1]
26 [15,
29]
0.8
[0.6,
1.0]
0.5
[0.3,
0.8]
214
[210,
220]
0.09
[0.06,
0.13]
0.11
[0.07,
0.13]
2.1
[1.8,
2.1]
25 [24,
33]
0.9
[0.8,
1.3]
0.7
[0.4,
1.2]
180
[150,
190]
0.08
[0.06,
0.11]
0.12
[0.07,
0.12]
1.9
[1.7,
2.2]
24 [18,
30]
0.8
[0.6,
1.0]
0.6
[0.5,
0.9]
225
[160,
245]
0.08
[0.06,
0.10]
0.12
[0.10,
0.14]
2.2
[1.7,
2.4]
22 [21,
34]
0.7
[0.4,
1.3]
0.6
[0.6,
1.0]
160
[130,
200]*
0.08
[0.06,
0.12]
0.12
[0.08,
0.12]
DT=deceleration time; E’=early diastolic motion of the mitral annulus at the (s) septal and (l) lateral positions; LADI=left atrium
dimension index; LASVI=left atrium volume index at end-systole; TD= LVAD speed turndown. Values are expressed as median [25th,
75th percentiles], *p<0.05 vs. pre-TD.