**Introduction/Hypothesis:**
Heart transplantation is the definitive therapeutic option for end-stage heart failure patients, but the scarcity of donor organs necessitates a careful selection process. Mechanical circulatory support devices play a crucial role in bridging patients to transplantation. This study aims to identify echocardiographic factors associated with the use of MCS devices before heart transplantation.

**Methods**
This was a single-center retrospective cohort analysis from 2019 to 2023 and included 144 patients. Echocardiographic factors were extracted for each patient prior to MCS implantation for cardiac transplantation.

**Results**
Echocardiography factors which were found to be associated with a higher odds of MCS before transplantation were elevated heart rate during time of TTE (OR: 1.04 [95% CI: 1.02 – 1.06]), elevated diastolic blood pressure during TTE (OR: 1.04 [95% CI: 1.00 – 1.07]), elevated E/A ratio (OR: 1.69 [95% CI: 1.20 – 2.45]), elevated TR velocity (OR: 3.85 [95% CI: 1.84 – 8.76]), increased LVIDd (OR: 1.05 [95% CI: 1.02 – 1.08]), increased LVISd (OR: 1.04 [95% CI: 1.02 – 1.07]),  and elevated RVSP (OR: 1.07 [95% CI: 1.03 – 1.10]). Factors that were found to have decreased odds of MCS before transplantation were increased LVEF (OR: 0.96 [95% CI: 0.93 – 0.98]), increased pulse pressure during TTE (OR: 0.97 [95% CI: 0.94 – 1.00]), and increased LVOT VTI (OR: 0.85 [95% CI: 0.78 – 0.92]). The interquartile range (IQR) for LVOT VTI was 4.4 – 10.7 (Q1), 10.8 – 13.9 (Q2), 14 – 17 (Q3), and 17.1 – 30.6 (Q4). The Kaplan-Meier survival curve which was generated to compare the IQR for the LVOT VTI showed that a significant difference was apparent between the groups (Figure 1; p-value < 0.05). A Cox-proportional hazards model was generated using Q1 as the reference standard. This demonstrated that in comparison to the lowest IQR those with Q3 or Q4 LVOT VTIs had a statistically significantly lower risk of needing MCS (HR: 0.42 [95% CI: 0.21 – 0.84]), and (HR: 0.22 [95% CI: 0.10 – 0.52]).

**Conclusion**
The study introduces LVOT VTI as a potential non-invasive parameter for determining patient selection for MCS implantation prior to transplant.



Echocardiogram Parameters Associated with Use of Temporary Mechanical Circulatory Support Devices Prior to Heart Transplant

This course will explore basic and cutting-edge imaging techniques to improve patient care and hone individual skills in performance and interpretation of echocardiography, nuclear cardiology, cardiac computed tomography, and cardiovascular magnetic resonance imaging. Days will reinforce how cardiovascular imaging may improve comprehension in ischemic heart disease, structural heart disease, cardiomyopathies, and heart failure. Experts will utilize novel techniques to reinforce key topics including taped interventional cases and a strong emphasis on case presentations.