Related Experiment Video
Updated: Jan 19, 2026
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Clinical implications of LDH isoenzymes in hemolysis and continuous-flow left ventricular assist device-induced
Jonathan S Gordon1, Chelsey T Wood1, Jessica G Y Luc2
1Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Insights
Diagnosing pump thrombosis in continuous-flow left ventricular assist devices (CF-LVADs) is challenging. Analyzing lactate dehydrogenase (LDH) isoenzymes offers a promising method to differentiate pump thrombosis from other conditions.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Clinical Diagnostics
Background:
- Pump-induced thrombosis is a critical complication of continuous-flow left ventricular assist devices (CF-LVADs), leading to severe adverse events like stroke and pump failure.
- Accurate diagnosis of CF-LVAD pump thrombosis is difficult due to the lack of direct measurement methods during device support.
- Elevated lactate dehydrogenase (LDH) is used to suspect thrombosis, but it is a nonspecific marker.
Purpose of the Study:
- To review the utility of lactate dehydrogenase (LDH) isoenzymes in differentiating hemolysis caused by CF-LVAD pump thrombosis from other conditions.
- To highlight the diagnostic value of specific LDH isoenzyme patterns in CF-LVAD complications.
Main Methods:
- Literature review of studies investigating lactate dehydrogenase (LDH) isoenzymes in the context of continuous-flow left ventricular assist device (CF-LVAD) pump thrombosis.
- Analysis of reported LDH isoenzyme profiles associated with CF-LVAD pump thrombosis and other hemolytic conditions.
Main Results:
- Continuous-flow left ventricular assist device (CF-LVAD) pump thrombosis is associated with specific lactate dehydrogenase (LDH) isoenzyme patterns, including elevated LDH-1 and LDH-2.
- Decreased levels of LDH-4 and LDH-5 are also observed in CF-LVAD pump thrombosis.
- These specific LDH isoenzyme profiles may help distinguish pump thrombosis-related hemolysis from other causes.
Conclusions:
- Lactate dehydrogenase (LDH) isoenzyme analysis provides a more specific diagnostic approach for identifying pump-induced thrombosis in continuous-flow left ventricular assist devices (CF-LVADs).
- Understanding LDH isoenzyme patterns is crucial for clinicians to accurately diagnose and manage CF-LVAD complications, improving patient outcomes.
Abstract:
Pump-induced thrombosis continues to be a major complication of continuous-flow left ventricular assist devices (CF-LVADs), which increases the risks of thromboembolic stroke, peripheral thromboembolism, reduced pump flow, pump failure, cardiogenic shock, and death. This is confounded by the fact that there is currently no direct measure for a proper diagnosis during pump support. Given the severity of this complication and its required treatment, the ability to accurately differentiate CF-LVAD pump thrombosis from other complications is vital. Hemolysis measured by elevated lactate dehydrogenase (LDH) enzyme levels, when there is clinical suspicion of pump-induced thrombosis, is currently accepted as an important metric used by clinicians for diagnosis; however, LDH is a relatively nonspecific finding. LDH exists as five isoenzymes in the body, each with a unique tissue distribution. CF-LVAD pump thrombosis has been associated with elevated serum LDH-1 and LDH-2, as well as decreased LDH-4 and LDH-5. Herein, we review the various isoenzymes of LDH and their utility in differentiating hemolysis seen in CF-LVAD pump thrombosis from other physiologic and pathologic conditions as reported in the literature.
Related Concept Videos
09:15In Vitro Thrombosis Test for Ventricular Assist Devices
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
08:49Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
10:37Ferric Chloride-induced Murine Thrombosis Models
07:55Echocardiographic Characterization of Left Ventricular Structure, Function, and Coronary Flow in Neonate Mice