Related Experiment Videos
Left ventricular assist system support is associated with persistent inflammation and temporary immunosuppression
1Department of Cardiothoracic Surgery, Münster University Hospital, Germany.
The Thoracic and Cardiovascular Surgeon
|April 28, 1999
Summary
Mechanical circulatory support via left-ventricular assist devices (LVAS) in end-stage heart failure patients exacerbates immune system alterations. Both LVAS support and advanced heart failure impact immune homeostasis, with LVAS potentially increasing inflammation.
Area of Science:
- Immunology
- Cardiology
- Medical Devices
Background:
- End-stage heart failure significantly impacts immune homeostasis.
- The specific contribution of mechanical circulatory support devices versus the underlying disease to immune perturbation remains unclear.
Purpose of the Study:
- To compare immune status in patients bridged with a left-ventricular assist system (LVAS) to those managed medically.
- To elucidate the role of LVAS in immune dysregulation in heart failure patients.
Main Methods:
- Prospective sampling of interleukin-6, T-cell, and monocyte subsets in 11 LVAS patients and 15 medically treated patients.
- Comparison of these subsets to 32 healthy controls at baseline and follow-up points.
Main Results:
- LVAS patients exhibited higher C-reactive protein, leukocyte, neutrophil, and monocyte levels.
- LVAS patients showed lower CD3+, CD4+, CD3+/CD45 RO T-cell, and natural killer cell counts compared to medically treated patients.
- Both groups displayed heightened inflammatory activation and reduced immunocompetence relative to controls.
Conclusions:
- End-stage heart failure patients exhibit immune alterations, with LVAS bridging leading to more pronounced inflammatory marker activation.
- The Novacor LVAS may contribute to increased inflammation and temporary suppression of immunocompetent cells.
- Distinguishing the impact of advanced heart failure from the LVAS device on immune response is crucial.