Clinical Impact of Heart Failure Readmissions in HeartMate 3 Left Ventricular Assist Device Recipients

Area of Science:

• Cardiology
• Medical Devices
• Clinical Outcomes

Background:

• Heart failure (HF) readmissions significantly impact morbidity and quality of life in patients with durable left ventricular assist devices (LVADs).
• The HeartMate 3 (HM3) device is a common LVAD, but understanding HF readmission patterns post-implantation is critical.

Purpose of the Study:

• To investigate the clinical impact and frequency of heart failure readmissions after HeartMate 3 (HM3) LVAD implantation.
• To identify predictors of HF readmissions and their association with mortality in HM3 LVAD recipients.

Main Methods:

• Single-center analysis of 273 patients who underwent HM3 LVAD implantation from January 2015 to December 2021.
• Utilized cumulative incidence functions and multistate models to analyze HF readmissions and mortality transitions.
• Assessed preimplant factors such as diabetes mellitus and body mass index as potential predictors.

Main Results:

• 29% of patients experienced at least one HF readmission.
• HF readmissions were more frequent than death at both 1 and 4 years post-implantation (1 year: 20.8% vs. 8.5%; 4 years: 30.5% vs. 23.4%).
• Preimplant diabetes and higher BMI predicted HF readmission; mortality risk increased significantly with each subsequent HF readmission.

Conclusions:

• HF readmissions represent a substantial source of morbidity for HM3 LVAD patients.
• Recurrent HF readmissions are strongly associated with a stepwise increase in mortality.
• Targeted strategies are needed to prevent recurrent HF readmissions and improve long-term outcomes in this population.