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Endocrine Challenges in Patients with Continuous-Flow Left Ventricular Assist Devices
Gennaro Martucci1, Federico Pappalardo1, Harikesh Subramanian2
1Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90133 Palermo, Italy.
Nutrients
|April 3, 2021
Summary
Left ventricular assist devices (LVADs) improve outcomes in advanced heart failure. This review examines how LVADs impact endocrine function and discusses therapeutic strategies for managing hormonal imbalances in these patients.
Area of Science:
- Cardiology
- Endocrinology
- Critical Care Medicine
Background:
- Heart failure (HF) is a major global health burden, associated with significant morbidity and mortality.
- Continuous-flow left ventricular assist devices (LVADs) are advanced mechanical circulatory support systems improving outcomes in advanced HF.
- Metabolic and endocrine dysfunctions are increasingly recognized as complications or associations of HF, representing potential therapeutic targets.
Purpose of the Study:
- To review the impact of LVAD support on endocrine function in heart failure patients.
- To explore how LVADs may influence organ perfusion and neuro-hormonal status, potentially mitigating endocrine dysfunction.
- To summarize current therapeutic strategies for endocrine challenges in LVAD recipients.
Main Methods:
- Comprehensive literature review of studies on endocrine function in LVAD patients.
- Analysis of pathophysiological states relevant to endocrine challenges in this population.
- Synthesis of current therapeutic recommendations for specific endocrine dysfunctions.
Main Results:
- LVAD support may improve endocrine function by enhancing organ perfusion and neuro-hormonal balance.
- Endocrine health is critical for homeostasis, recovery from critical illness, cardiac contractility, immune function, and rehabilitation post-LVAD.
- Specific endocrine issues include thyroid dysfunction, and deficiencies in vitamin D, erythropoietin, and testosterone.
Conclusions:
- Optimizing endocrine function is crucial for improving outcomes in patients with LVADs.
- Targeted management of thyroid, vitamin D, erythropoietin, and testosterone levels can support recovery and rehabilitation.
- Further research is needed to fully elucidate the interplay between LVADs and endocrine health.
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