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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.6K
Metabolic Dysfunction in Continuous-Flow Left Ventricular Assist Devices Patients and Outcomes
Ann B Nguyen1, Teruhiko Imamura1, Stephanie Besser1
1Section of Cardiology Department of Medicine University of Chicago IL.
Journal of the American Heart Association
|November 14, 2019
Summary
Continuous-flow left ventricular assist devices (CF-LVADs) significantly improve metabolic status in advanced heart failure patients. Achieving normal metabolic status after CF-LVAD implantation correlates with better survival rates and fewer heart failure readmissions.
Area of Science:
- Cardiology
- Metabolic Medicine
- Medical Devices
Background:
- Metabolic impairment is prevalent in advanced heart failure.
- Continuous-flow left ventricular assist devices (CF-LVADs) improve hemodynamics but their metabolic impact is unknown.
Purpose of the Study:
- To evaluate metabolic status changes after CF-LVAD implantation.
- To correlate metabolic status with patient outcomes.
Main Methods:
- Prospective study of 106 advanced heart failure patients undergoing CF-LVAD implantation.
- Metabolic evaluation included hemoglobin A1C, testosterone, and thyroid function (TSH, free T4) pre- and post-implantation.
- Normal metabolic status defined by normal hemoglobin A1C, testosterone, and TSH levels.
Main Results:
- Pre-implantation: 75% insulin resistance, 86% men/39% women low testosterone, 44% abnormal thyroid function.
- Significant improvements observed in hemoglobin A1C, free testosterone, and TSH post-implantation (P<0.001).
- Normal post-implantation hemoglobin A1C (<5.7%) associated with higher 1-year survival free of readmissions (78% vs 23%; P<0.001).
- Normal post-implantation metabolic status linked to improved 1-year survival free of readmissions (92% vs 54%; P=0.04).
Conclusions:
- Metabolic dysfunction is common in advanced heart failure and improves with CF-LVADs.
- Normal metabolic status post-CF-LVAD implantation is a significant predictor of better long-term outcomes, including survival and reduced readmissions.
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