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Improved 6 Minute Walk Distance and Brain-Type Natriuretic Peptide After Continuous-Flow Ventricular Assist Device

Jason F Goldberg1, Robin S Schlosser2, James G Walrath2

  • 1From the University of Tennessee Health Sciences Center, Memphis, Tennessee.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|August 31, 2018
PubMed

Insights

Children show improved functional recovery after continuous-flow ventricular assist device (CF-VAD) implantation, with significant gains in 6-minute walk distance and BNP levels within the first 90 days post-surgery.

Area of Science:

  • Pediatric Cardiology
  • Mechanical Circulatory Support
  • Rehabilitation Medicine

Background:

  • Continuous-flow ventricular assist devices (CF-VADs) are increasingly used in pediatric patients with heart failure.
  • Limited data exist on functional recovery and rehabilitation potential following CF-VAD implantation in children.
  • Understanding recovery trajectories is crucial for optimizing patient management and rehabilitation strategies.

Purpose of the Study:

  • To investigate the functional recovery and rehabilitation potential in pediatric patients after CF-VAD implantation.
  • To assess changes in 6-minute walk distance (6MWD) and brain-type natriuretic peptide (BNP) levels over time.
  • To determine the time course of functional improvement following CF-VAD placement in children.

Main Methods:

  • Retrospective cohort study of 27 pediatric patients (<18 years) who received CF-VAD implantation.
  • Evaluation of 6-minute walk distance (6MWD) and brain-type natriuretic peptide (BNP) levels within 365 days post-implantation.
  • Analysis of data stratified into periods before and after 90 days to identify potential plateaus in recovery.

Main Results:

  • Significant improvement in 6MWD (12% predicted per 30 days) and a decrease in BNP (-59% per 30 days) were observed within the first 90 days post-implantation (P < 0.01).
  • No significant changes in 6MWD (0.6% predicted per 30 days) or BNP (1.2% per 30 days) were detected after 90 days (P > 0.48).
  • Functional recovery, indicated by 6MWD and BNP, demonstrated a significant improvement primarily within the initial 90 days after CF-VAD placement.

Conclusions:

  • Pediatric patients exhibit significant functional recovery in the first 90 days after CF-VAD implantation.
  • The observed improvements in 6MWD and BNP suggest a time-limited recovery window post-device placement.
  • Routine monitoring of 6MWD and BNP is recommended for assessing functional recovery in children following CF-VAD therapy.

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