PURPOSE: Implantation of a left ventricular assist device (LVAD) is an established treatment for end-stage heart failure. Right ventricular dysfunction develops in 20%-50% of patients after device implantation, leading to prolonged hospital stays and elevated mortality rates. However, prediction of right ventricular failure remains difficult. METHODS: A total of 40 patients who received an LVAD for chronic end-stage heart failure between May 2001 and December 2002 were evaluated. The patients were divided retrospectively into two groups: group I (n = 26), with no apparent postoperative right ventricular failure; and group II (n = 14), with right ventricular failure after implantation defined by the presence of two of the following criteria during the first week after surgery: mean arterial pressure ≤ 55 mmHg, central venous pressure ≥ 16 mmHg, mixed venous saturation ≤ 55%, cardiac index <2 l/min/m(2), inotropic support score >20 units or an apparent need for mechanical right ventricular support. Hemodynamic, echocardiographic, neurohumoral, and inflammatory parameters were evaluated 24 h before implantation of the LVAD. RESULTS: Levels of procalcitonin, neopterin, n-terminalpro-brain natriuretic peptide, and big endothelin-1 were significantly lower in group I: 0.106 vs. 0.322 ng/ml, P = 0.048; 10.5 vs. 20.7 ng/ml, P = 0.018; 6322 vs. 17174 pg/ml, P = 0.032; 1.6 vs. 19.5 pg/ml, P = 0.02, respectively. Levels of creatinine kinase and creatinine were significantly lower in group I than in group II: 24 vs. 40 U/l, P = 0.034; 1.3 vs. 2.3 mg/dl, P = 0.008, respectively. CONCLUSION: Preoperative evaluation of markers of inflammation and neurohumoral activation may provide additional information for predicting right ventricular failure after implantation of an LVAD.
PURPOSE: Implantation of a left ventricular assist device (LVAD) is an established treatment for end-stage heart failure. Right ventricular dysfunction develops in 20%-50% of patients after device implantation, leading to prolonged hospital stays and elevated mortality rates. However, prediction of right ventricular failure remains difficult. METHODS: A total of 40 patients who received an LVAD for chronic end-stage heart failure between May 2001 and December 2002 were evaluated. The patients were divided retrospectively into two groups: group I (n = 26), with no apparent postoperative right ventricular failure; and group II (n = 14), with right ventricular failure after implantation defined by the presence of two of the following criteria during the first week after surgery: mean arterial pressure ≤ 55 mmHg, central venous pressure ≥ 16 mmHg, mixed venous saturation ≤ 55%, cardiac index <2 l/min/m(2), inotropic support score >20 units or an apparent need for mechanical right ventricular support. Hemodynamic, echocardiographic, neurohumoral, and inflammatory parameters were evaluated 24 h before implantation of the LVAD. RESULTS: Levels of procalcitonin, neopterin, n-terminalpro-brain natriuretic peptide, and big endothelin-1 were significantly lower in group I: 0.106 vs. 0.322 ng/ml, P = 0.048; 10.5 vs. 20.7 ng/ml, P = 0.018; 6322 vs. 17174 pg/ml, P = 0.032; 1.6 vs. 19.5 pg/ml, P = 0.02, respectively. Levels of creatinine kinase and creatinine were significantly lower in group I than in group II: 24 vs. 40 U/l, P = 0.034; 1.3 vs. 2.3 mg/dl, P = 0.008, respectively. CONCLUSION: Preoperative evaluation of markers of inflammation and neurohumoral activation may provide additional information for predicting right ventricular failure after implantation of an LVAD.
Authors: Ronald Van Beneden; Olivier Gurné; Philippe L Selvais; Sylvie A Ahn; Annie R Robert; Jean-Marie Ketelslegers; Hubert G Pouleur; Michel F Rousseau Journal: J Card Fail Date: 2004-12 Impact factor: 5.712
Authors: A L Caforio; J H Goldman; M K Baig; N J Mahon; A J Haven; B E Souberbielle; D W Holt; A G Dalgleish; W J McKenna Journal: Eur J Heart Fail Date: 2001-03 Impact factor: 15.534
Authors: T A McDonagh; S D Robb; D R Murdoch; J J Morton; I Ford; C E Morrison; H Tunstall-Pedoe; J J McMurray; H J Dargie Journal: Lancet Date: 1998-01-03 Impact factor: 79.321
Authors: Evgenij V Potapov; Yuguo Weng; Harald Hausmann; Michael Kopitz; Miralem Pasic; Roland Hetzer Journal: Ann Thorac Surg Date: 2003-12 Impact factor: 4.330
Authors: R L Kormos; T A Gasior; A Kawai; S M Pham; S Murali; B G Hattler; B P Griffith Journal: J Thorac Cardiovasc Surg Date: 1996-04 Impact factor: 5.209
Authors: Franz Hartmann; Milton Packer; Andrew J S Coats; Michael B Fowler; Henry Krum; Paul Mohacsi; Jean L Rouleau; Michal Tendera; Alain Castaigne; Jürgen Trawinski; Ildiko Amann-Zalan; Silke Hoersch; Hugo A Katus Journal: Eur J Heart Fail Date: 2004-03-15 Impact factor: 15.534
Authors: Melana Yuzefpolskaya; Bruno Bohn; Mojdeh Nasiri; Amelia M Zuver; Drew D Onat; Eugene A Royzman; Joseph Nwokocha; Melissa Mabasa; Alberto Pinsino; Danielle Brunjes; Antonia Gaudig; Autumn Clemons; Pauline Trinh; Stephania Stump; Marla J Giddins; Veli K Topkara; A Reshad Garan; Koji Takeda; Hiroo Takayama; Yoshifumi Naka; Maryjane A Farr; Renu Nandakumar; Anne-Catrin Uhlemann; Paolo C Colombo; Ryan T Demmer Journal: J Heart Lung Transplant Date: 2020-02-13 Impact factor: 10.247
Authors: Salim Hayek; Daniel B Sims; David W Markham; Javed Butler; Andreas P Kalogeropoulos Journal: Circ Cardiovasc Imaging Date: 2014-03 Impact factor: 7.792
Authors: Marijan Koprivanac; Marta Kelava; Franjo Sirić; Vincent B Cruz; Nader Moazami; Tomislav Mihaljević Journal: Croat Med J Date: 2014-12 Impact factor: 1.351