Review
Cardiac & Cardiovascular Systems
Stefan Frantz, Moritz Jens Hundertmark, Jeanette Schulz-Menger, Frank Michael Bengel, Johann Bauersachs
Summary: Most patients survive acute myocardial infarction, but the prevalence of heart failure is increasing, leading to economic strain on healthcare systems. Pathological changes in the heart significantly impact patient outcomes. Risk factors like diabetes, chronic obstructive pulmonary disease, and female sex can distinctively shape the progression towards heart failure.
EUROPEAN HEART JOURNAL
(2022)
Review
Cardiac & Cardiovascular Systems
K. Candis Jones-Ungerleider, Angela Rose, Kevin Knott, Sarah Comstock, Jonathan. W. W. Haft, Francis. D. D. Pagani, Paul. C. C. Tang
Summary: Women with advanced heart failure receive advanced surgical therapies at a lower rate compared to men, and the reasons for this disparity are largely unknown. Existing research indicates that females have higher mortality and experience bleeding, clotting, and right ventricular failure more frequently following LVAD implantation. However, there is limited understanding of the pre-operative factors that contribute to the lower-than-expected LVAD implant rates in this population. More focused research is needed to identify and address disparities in advanced heart failure therapy delivery for women and other underserved populations.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Magnus Nakrem Lyngbakken, Brede Kvisvik, Trygve Berge, Mohammad Osman Pervez, Erika Nerdrum Aagaard, Inger Ariansen, Torbjorn Omland, Arnljot Tveit, Kjetil Steine, Helge Rosjo
Summary: This study assessed the relationship between serial blood pressure measurements and the risk of cardiovascular disease. The results showed that serial blood pressure measurements are more closely associated with left ventricular remodeling and cardiovascular outcomes than individual blood pressure measurements.
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2023)
Article
Cardiac & Cardiovascular Systems
Dominic Emerson, Joanna Chikwe, Pedro Catarino, Mohamed Hassanein, Luqin Deng, Ryan S. Cantor, Amy Roach, Robert Cole, Fardad Esmailian, Jon Kobashigawa, Jaime Moriguchi, James K. Kirklin
Summary: In contemporary practice, elderly patients receiving LVADs showed improved survival, increased functional capacity, enhanced quality of life, and fewer complications compared with younger patients.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Biochemistry & Molecular Biology
Veera Ganesh Yerra, Andrew Advani
Summary: Heart failure is a major cause of morbidity and mortality, and new treatments are urgently needed. Pathological ventricular remodelling, which involves changes in cardiac cellular composition, is a major antecedent of heart failure. Among the immune cell subpopulations involved, CCR2(+) macrophages play a crucial role in adverse remodeling.
Article
Cardiac & Cardiovascular Systems
Pankaj Puar, Makoto Hibino, C. David Mazer, Andrew T. Yan, Arjun K. Pandey, Adrian Quan, Hwee Teoh, David A. Hess, Raj Verma, Kim A. Connelly, Subodh Verma
Summary: The study found that empagliflozin use for 6 months resulted in a significant reduction in left ventricular mass indexed to body surface area (LVMi) in patients with type 2 diabetes and coronary artery disease. Further analysis showed that patients with higher baseline LVMi experienced greater improvement with the use of the drug.
CARDIOVASCULAR DIABETOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Ze Ming Goh, Nithin Balasubramanian, Samer Alabed, Krit Dwivedi, Yousef Shahin, Alexander M. K. Rothman, Pankaj Garg, Allan Lawrie, David Capener, A. A. Roger Thompson, Faisal Alandejani, Jim M. Wild, Christopher S. Johns, Robert A. Lewis, Rebecca Gosling, Michael Sharkey, Robin Condliffe, David G. Kiely, Andrew J. Swift
Summary: This study investigated the prognostic value of patterns of right ventricular adaptation in patients with pulmonary arterial hypertension (PAH) using cardiac magnetic resonance imaging. The results showed that patients in different volume/mass groups had different survival outcomes, with those in the high-volume-low-mass group having a higher risk of treatment failure.
Review
Cardiac & Cardiovascular Systems
Claudio A. Bravo, Andrew G. Navarro, Karanpreet K. Dhaliwal, Maziar Khorsandi, Jeffrey E. Keenan, Parvathi Mudigonda, Kevin D. O'Brien, Claudius Mahr
Summary: Left ventricular assist device (LVAD) therapy is a life-saving option for patients with advanced heart failure who do not respond to medical treatment. However, a significant percentage of LVAD patients develop right heart failure (RHF), which is associated with poor outcomes. The mechanisms of RHF are complex, involving patient factors, surgical factors, and hemodynamic factors. Despite advances in surgical techniques and LVAD technology, RHF remains a major cause of morbidity and mortality among LVAD patients. Current medical therapies for RHF are limited, and cardiac transplantation or supportive management are the only options for these patients. Efforts to predict the risk of RHF in LVAD patients have been challenging, with varying definitions of RHF in different studies. Additionally, most research in this field has focused on early-onset RHF, while late-onset RHF is increasingly recognized as a significant problem. This review aims to describe the unique physiology of the right ventricle and the changes caused by LVADs that may contribute to both early- and late-onset RHF. The available treatments for RHF, including mechanical circulatory support and medical therapies, will also be analyzed.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Medicine, General & Internal
Alessia Gambaro, Gianmarco Lombardi, Francesco Onorati, Leonardo Gottin, Flavio Luciano Ribichini
Summary: LVAD implantation has complex effects on the kidneys, particularly regarding renal function. Creatinine-based eGFR formulas help in assessing patient prognosis, while deterioration in renal function in LVAD patients negatively impacts outcomes.
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2021)
Article
Cardiac & Cardiovascular Systems
Timothy J. George, Jenelle Sheasby, Greg Milligan, Nitin Kabra, J. Michael Dimaio, David A. Rawitscher, Aasim Afzal
Summary: Although left ventricular assist device (LVAD) implant is associated with increased survival in patients with end-stage heart failure, severe right ventricular failure requiring right ventricular assist device (RVAD) placement is associated with increased short-term morbidity and mortality. This retrospective study evaluated LVAD implants at a nontransplant center and found that the need for a RVAD was associated with higher operative mortality, decreased 1-year and 2-year survival rates. However, in patients who survived their index hospitalization, the mortality rates were similar. Carefully selected patients with biventricular failure may benefit from an LVAD implant, even if an RVAD is needed.
AMERICAN JOURNAL OF CARDIOLOGY
(2023)
Article
Medicine, General & Internal
Alexander A. Brescia, Tessa M. F. Watt, Francis D. Pagani, Thomas M. Cascino, Min Zhang, Jeffrey S. McCullough, Supriya Shore, Donald S. Likosky, Keith D. Aaronson, Michael P. Thompson
Summary: The study found that a significant proportion of LVAD recipients are ineligible for clinical trials, and that mortality rates are higher among those who are ineligible compared to those who are eligible. The results suggest that criteria for clinical trial eligibility should be more reflective of real-world experience.
Article
Cardiac & Cardiovascular Systems
Ofer Havakuk, Aviram Hochstadt, Sapir Sadon, Michal Laurel Perl, Ben Sadeh, Assi Milwidsky, Orly Ran Sapir, Yoav Granot, Lior Lupu, Erez Levi, Ariel Farkash, Yanai Ben Gal, Shmuel Banai, Yan Topilsky
Summary: This study demonstrates that long-term stabilization of patients entering a left ventricular assist device (LVAD) program is possible with the use of aggressive conservative therapy.
Article
Hematology
Kristin Klaeske, Maja-Theresa Dieterlen, Sandra Eifert, Ute Scholz, Jens Garbade, Khalil Jawad, Franz Sieg, Michael A. Borger, Anna L. Meyer
Summary: This study compared platelet receptor expression patterns and oxidative stress levels between LVAD patients with non-surgical bleeding (NSB) and those without coagulation disorders. The findings suggested that changes in three platelet receptors (GPIb alpha, P-selectin, and PECAM-1) and elevated oxidative stress may play a role in bleeding complications following LVAD implantation.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Cardiac & Cardiovascular Systems
Jan D. Schmitto, Steven Shaw, Jens Garbade, Finn Gustafsson, Michiel Morshuis, Daniel Zimpfer, Jacob Lavee, Yuriy Pya, Michael Berchtold-Herz, Aijia Wang, Carlo Gazzola, Evgenij Potapov, Diyar Saeed
Summary: The long-term survival rate for primary implants of HeartMate 3 is 63.3%, and improvements in adverse events reduction, quality of life, and functional capacity were observed in patients with advanced heart failure during extended follow-up.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Anubodh S. Varshney, Ersilia M. DeFilippis, Jennifer A. Cowger, Ivan Netuka, Sean P. Pinney, Michael M. Givertz
Summary: With the increasing prevalence of advanced heart failure, treatment options such as heart transplantation and LVAD support have shown to improve quality of life and extend survival. Recent advancements, including the use of HeartMate 3 in clinical practice and revisions to the organ allocation system, have led to better management of LVAD-related complications. Although contemporary LVAD recipients have higher illness severity preoperatively, they have higher survival rates and lower adverse event rates compared to previous eras. However, challenges such as bleeding, infection, neurologic events, and right ventricular failure still limit the wider implementation of LVAD support. Ongoing efforts to optimize management of current LVAD devices and develop next-generation devices are expected to further enhance outcomes for patients with advanced heart failure.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)