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Increased cyclic guanosine monophosphate levels and continuous-flow left-ventricular assist devices: Implications for

Liza Grosman-Rimon1, Laura C Tumiati2, Avi Fuks2

  • 1Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.

The Journal of Thoracic and Cardiovascular Surgery
|October 31, 2015
PubMed

Insights

Elevated cyclic guanosine monophosphate (cGMP) levels are linked to gastrointestinal (GI) bleeding in continuous-flow left ventricular assist device (CF-LVAD) recipients. This finding suggests cGMP may serve as a clinical marker for GI bleeding risk in these patients.

Area of Science:

  • Cardiovascular Science
  • Gastroenterology
  • Biomarker Research

Background:

  • Continuous-flow left ventricular assist devices (CF-LVADs) are crucial for heart failure management.
  • Gastrointestinal (GI) bleeding is a significant complication in CF-LVAD recipients.
  • The underlying mechanisms linking CF-LVAD support to GI bleeding require further elucidation.

Purpose of the Study:

  • To investigate elevated cyclic guanosine monophosphate (cGMP) levels in CF-LVAD recipients.
  • To determine the association between high cGMP levels and the risk of GI bleeding events.
  • To explore the relationship between cGMP, nitric oxide, platelet markers, and inflammatory mediators in CF-LVAD patients.

Main Methods:

  • Measured cGMP, nitric oxide, platelet activation markers, platelet-derived growth factors (PDGF), and C-reactive protein (CRP) in 19 CF-LVAD recipients, 21 heart failure patients, and 19 healthy controls.
  • Analyzed correlations between cGMP levels, pulsatility index (in HeartMate II users), and bleeding events.
  • Compared biomarker levels across the three participant groups.

Main Results:

  • CF-LVAD recipients and heart failure patients exhibited significantly higher cGMP levels compared to healthy controls.
  • Higher cGMP levels were significantly associated with GI bleeding events, but not with other types of bleeding.
  • Low pulsatility index in HeartMate II users correlated with elevated cGMP levels.

Conclusions:

  • Significantly elevated cGMP levels are associated with GI bleeding in CF-LVAD recipients, even with high CRP levels.
  • Elevated cGMP may serve as a potential clinical marker for predicting GI bleeding risk in CF-LVAD patients.
  • Further research is warranted to validate cGMP as a predictive biomarker for GI bleeding in CF-LVAD recipients.
Abstract

Keywords:
continuous-flow left ventricular assist devicecyclic guanosine monophosphategastrointestinal bleeding

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