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Updated: Nov 20, 2025

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Angiotensin receptor neprilysin inhibitor use in patients with left ventricular assist devices: A single-center

Shudhanshu Alishetti1, Lorenzo Braghieri2, Douglas L Jennings2,3

  • 1Division of Cardiology, Department of Medicine, Weill Cornell Medical Center, New York, NY, USA.

The International Journal of Artificial Organs
|January 20, 2021
PubMed

Insights

Angiotensin receptor neprilysin inhibitor (ARNi) therapy significantly reduced NT-proBNP levels in patients with left ventricular assist devices (LVADs). This study suggests ARNi is a safe and effective medical therapy for advanced heart failure patients with LVADs.

Area of Science:

  • Cardiology
  • Medical Devices
  • Pharmacology

Background:

  • Left ventricular assist devices (LVADs) are a key therapy for advanced heart failure (ACC/AHA Stage D).
  • Optimal medical management for patients with LVADs remains uncertain.
  • Angiotensin receptor neprilysin inhibitors (ARNi) represent a newer class of heart failure medication.

Purpose of the Study:

  • To assess the safety and efficacy of ARNi therapy in patients with LVADs.
  • To evaluate changes in NT-proBNP levels as a primary outcome measure.
  • To examine the impact of ARNi on renal function and electrolytes.

Main Methods:

  • Retrospective analysis of 30 patients implanted with LVADs between 2010 and 2019.
  • Patients received ARNi therapy for at least 3 months.
  • Comparison of NT-proBNP levels at initiation, 3 months, and 6 months post-ARNi initiation.

Main Results:

  • A significant decrease in NT-proBNP levels was observed from baseline (1265 pg/mL) to 3 months (750 pg/mL) and 6 months (764 pg/mL) (p=0.01).
  • 18 patients (60%) transitioned to ARNi from ACE inhibitors or ARBs.
  • No significant changes in serum creatinine, BUN, or potassium levels were noted.

Conclusions:

  • ARNi therapy is associated with significant reductions in NT-proBNP levels in LVAD patients.
  • ARNi therapy appears safe regarding renal function and electrolytes in this LVAD cohort.
  • Further prospective studies are warranted to confirm these findings.

Keywords:
Cardiac assist and artificial heartassisted circulation physiologycardiac drugscongestive heart failureventricular assist devices

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