Your browser doesn't support javascript.
loading
Left Ventricular Hemodynamics and Relationship With Myocardial Recovery and Optimization in Patients Supported on CF-LVAD Therapy.
Rosenbaum, Andrew N; Geske, Jeffrey B; Stulak, John M; Kushwaha, Sudhir S; Clavell, Alfredo L; Behfar, Atta.
Afiliação
  • Rosenbaum AN; Department of Cardiovascular Medicine, Division of Circulatory Failure, Mayo Clinic, Rochester, Minnesota. Electronic address: Rosenbaum.Andrew@mayo.edu.
  • Geske JB; Department of Cardiovascular Medicine, Division of Structural Heart Disease, Mayo Clinic, Rochester, Minnesota.
  • Stulak JM; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
  • Kushwaha SS; Department of Cardiovascular Medicine, Division of Circulatory Failure, Mayo Clinic, Rochester, Minnesota; William J von Liebig Center for Transplantation and Clinical Regeneration. Mayo Clinic, Rochester, Minnesota.
  • Clavell AL; Department of Cardiovascular Medicine, Division of Circulatory Failure, Mayo Clinic, Rochester, Minnesota; William J von Liebig Center for Transplantation and Clinical Regeneration. Mayo Clinic, Rochester, Minnesota.
  • Behfar A; Department of Cardiovascular Medicine, Division of Circulatory Failure, Mayo Clinic, Rochester, Minnesota; William J von Liebig Center for Transplantation and Clinical Regeneration. Mayo Clinic, Rochester, Minnesota; VanCleve Cardiac Regenerative Medicine Program, Center for Regenerative Medicine, M
J Card Fail ; 28(5): 799-806, 2022 05.
Article em En | MEDLINE | ID: mdl-34929296
ABSTRACT

BACKGROUND:

Despite interest in left ventricular (LV) recovery, there is an absence of data on the relationship between intrinsic LV hemodynamics and both reverse remodeling on a continuous flow LV assist device (CF-LVAD) therapy. We hypothesized that the markers of intrinsic LV function would be associated with remodeling, optimization, and outcomes. METHODS AND

RESULTS:

Patients with continuous flow LVADs between 2015 and 2019 who underwent combined left and right heart catheterization ramp protocol at a single institution were enrolled. Patients were stratified by response to continuous flow LV assist device therapy full responders, partial responders, or nonresponders per the Utah-Inova criteria. Hemodynamic data, including LV hemodynamics of peak LV dP/dt and tau (τ) were obtained at each phase. The 1-year heart failure hospitalization-free survival was the primary end point. Among 61 patients included in the current study 38 (62%) were classified as nonresponders, 14 as partial responders (23%), and 9 as full responders (15%). The baseline LV dP/dt and τ varied by response status (P ≤ .02) and generally correlated with reverse remodeling on linear regression. Biventricular filling pressures varied with τ and there was an interaction effect of speed on the relationship between τ and pulmonary capillary wedge pressure (P = .04). Last, τ was a prognostic marker and associated with 1-year HF hospital-free survival (odds ratio 1.04, 95% confidence interval 1.00-1.07, P = .02 per millisecond increase).

CONCLUSIONS:

Significant correlations between τ and LV dP/dt and reverse remodeling were noted, with τ serving as a prognostic marker. A higher LVAD speed was associated with a greater reliance on LVAD for unloading. Future work should focus on defining the optimal level of LVAD support in relation to LV recovery.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Coração Auxiliar / Insuficiência Cardíaca Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: J Card Fail Assunto da revista: CARDIOLOGIA Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Coração Auxiliar / Insuficiência Cardíaca Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: J Card Fail Assunto da revista: CARDIOLOGIA Ano de publicação: 2022 Tipo de documento: Article