The possible molybdenum involvement on right ventricular performance in LVAD patients – initial study

Background: The left ventricular device (LVAD) implantation has evolved as a standard of care for heart failure (HF) patients. Optimal management is paramount, including additional strategies to achieve durable results. The study aimed to compare the right ventricular characteristics after LVAD implantation with trace element serum accumulation and to estimate the potential impact of specific trace elements on right ventricular performance. Method: There were 25 male patients in median (Q1 – Q3) age of 56 (51 – 62) years treated with left ventricular assist device implantation (HM3, Abbott Corp. USA) due to end-stage heart failure. Results: Patients presented with NYHA status I (12 (48%) patients) and II (13 (52%) patients) on the control follow-up check-ups, the median (Q1 – Q3) time of 421 (296 - 1277) days. The right ventricular diameter dilatation was observed in 7 (28%) patients and regression in 8 (32%) more patients. Among trace elements analysis, the significant differences related to molybdenum concentration between patients characterized by RV dilatation (1.76 (1.73 – 2.00) vs no-RV deterioration 2.61 (2.19 – 2.95) ug/l) was noted (p=0.030). While comparing the patients characterized by RV diameter regression (3.23 (2.92 – 3.61) ug/l vs control group (2.00 (1.73 – 2.19) ug/l), the significant difference related to molybdenum concentration was noticed (p=0.018). Conclusions: The low serum molybdenum concentration can be linked to adverse right ventricular performance after LVAD implantation, contrary to higher molybdenum values related to right ventricular regression.