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Erschienen in: Heart and Vessels 2/2020

20.07.2019 | Original Article

Significant impact of left ventricular assist device models on the value of flow-mediated dilation: effects of LVAD on endothelial function

verfasst von: Aya Watanabe, Eisuke Amiya, Masaru Hatano, Masafumi Watanabe, Atsuko Ozeki, Daisuke Nitta, Hisataka Maki, Yumiko Hosoya, Masaki Tsuji, Chie Bujo, Akihito Saito, Miyoko Endo, Yukie Kagami, Mariko Nemoto, Kan Nawata, Osamu Kinoshita, Mitsutoshi Kimura, Minoru Ono, Issei Komuro

Erschienen in: Heart and Vessels | Ausgabe 2/2020

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Abstract

The precise physiological changes associated with the use of left ventricular assist device (LVAD) are not well characterized. We examined the impact of changes in hemodynamic state using LVAD on endothelial function. We measured flow-mediated vasodilation (FMD) to evaluate endothelial vasodilator function of the brachial artery in 53 patients (dilated cardiomyopathy: 39, ischemic cardiomyopathy: 4, and others: 10) with an implanted LVAD (DuraHeart, EVAHEART, or HeartMate II). We found that FMD value in the HeartMateII LVAD group (9.3% ± 2.9%) was significantly higher than those in the other two groups (EVAHEART: 6.7% ± 2.8% and DuraHeart: 6.2% ± 4.0%). Other factors that affected the FMD value were age (r =  − 0.31, p = 0.026), Brinkman index (r =  − 0.30, p = 0.029); however, aortic opening, aortic regurgitation, and other hemodynamic parameters such as cardiac index or pulmonary capillary wedge pressure did not correlate with FMD. Multivariate analyses revealed that the difference among the LVAD models most significantly affected the FMD values after adjusting for age and smoking status (t = 2.6, p = 0.014). Event free survival rate of death and cerebral infarction was not significantly different according to the value of FMD. The difference among the LVAD groups most significantly affected the state of endothelial function and it had more impact than other clinical factors.
Literatur
1.
Zurück zum Zitat Witman MA, Garten RS, Gifford JR, Groot HJ, Trinity JD, Stehlik J, Nativi JN, Selzman CH, Drakos SG, Richardson RS (2015) Further peripheral vascular dysfunction in heart failure patients with a continuous-flow left ventricular assist device: the role of pulsatility. JACC Heart Fail 3(9):703–711CrossRef Witman MA, Garten RS, Gifford JR, Groot HJ, Trinity JD, Stehlik J, Nativi JN, Selzman CH, Drakos SG, Richardson RS (2015) Further peripheral vascular dysfunction in heart failure patients with a continuous-flow left ventricular assist device: the role of pulsatility. JACC Heart Fail 3(9):703–711CrossRef
2.
Zurück zum Zitat Lou X, Templeton DL, John R, Dengel DR (2012) Effects of continuous flow left ventricular assist device support on microvascular endothelial function. J Cardiovasc Transl Res 5(3):345–350CrossRef Lou X, Templeton DL, John R, Dengel DR (2012) Effects of continuous flow left ventricular assist device support on microvascular endothelial function. J Cardiovasc Transl Res 5(3):345–350CrossRef
3.
Zurück zum Zitat Katz SD, Biasucci L, Sabba C, Strom JA, Jondeau G, Galvao M, Solomon S, Nikolic SD, Forman R, LeJemtel TH (1992) Impaired endothelium-mediated vasodilation in the peripheral vasculature of patients with congestive heart failure. J Am Coll Cardiol 19:918–925CrossRef Katz SD, Biasucci L, Sabba C, Strom JA, Jondeau G, Galvao M, Solomon S, Nikolic SD, Forman R, LeJemtel TH (1992) Impaired endothelium-mediated vasodilation in the peripheral vasculature of patients with congestive heart failure. J Am Coll Cardiol 19:918–925CrossRef
4.
Zurück zum Zitat Kubo SH, Rector TS, Bank AJ, Williams RE, Heifetz SM (1991) Endothelium-dependent vasodilation is attenuated in patients with heart failure. Circulation 84:1589–1596CrossRef Kubo SH, Rector TS, Bank AJ, Williams RE, Heifetz SM (1991) Endothelium-dependent vasodilation is attenuated in patients with heart failure. Circulation 84:1589–1596CrossRef
5.
Zurück zum Zitat Amir O, Radovancevic B, Delgado RM 3rd, Kar B, Radovancevic R, Henderson M, Cohn WE, Smart FW (2006) Peripheral vascular reactivity in patients with pulsatile vs axial flow left ventricular assist device support. J Heart Lung Transplant 25(4):391–394CrossRef Amir O, Radovancevic B, Delgado RM 3rd, Kar B, Radovancevic R, Henderson M, Cohn WE, Smart FW (2006) Peripheral vascular reactivity in patients with pulsatile vs axial flow left ventricular assist device support. J Heart Lung Transplant 25(4):391–394CrossRef
6.
Zurück zum Zitat Takishima I, Nakamura T, Hirano M, Kitta Y, Kobayashi T, Fujioka D, Saito Y, Watanabe K, Watanabe Y, Mishina H, Obata JE, Kawabata K, Tamaru S, Kugiyama K (2012) Predictive value of serial assessment of endothelial function in chronic heart failure. Int J Cardiol 158:417–422CrossRef Takishima I, Nakamura T, Hirano M, Kitta Y, Kobayashi T, Fujioka D, Saito Y, Watanabe K, Watanabe Y, Mishina H, Obata JE, Kawabata K, Tamaru S, Kugiyama K (2012) Predictive value of serial assessment of endothelial function in chronic heart failure. Int J Cardiol 158:417–422CrossRef
7.
Zurück zum Zitat Katz SD, Hryniewicz K, Hriljac I, Balidemaj K, Dimayuga C, Hudaihed A, Yasskiy A (2005) Vascular endothelial dysfunction and mortality risk in patients with chronic heart failure. Circulation 111:310–314CrossRef Katz SD, Hryniewicz K, Hriljac I, Balidemaj K, Dimayuga C, Hudaihed A, Yasskiy A (2005) Vascular endothelial dysfunction and mortality risk in patients with chronic heart failure. Circulation 111:310–314CrossRef
8.
Zurück zum Zitat Meyer B, Mörtl D, Strecker K, Hülsmann M, Kulemann V, Neunteufl T, Pacher R, Berger R (2005) Flow-mediated vasodilation predicts outcome in patients with chronic heart failure: comparison with B-type natriuretic peptide. J Am Coll Cardiol 46:1011–1018CrossRef Meyer B, Mörtl D, Strecker K, Hülsmann M, Kulemann V, Neunteufl T, Pacher R, Berger R (2005) Flow-mediated vasodilation predicts outcome in patients with chronic heart failure: comparison with B-type natriuretic peptide. J Am Coll Cardiol 46:1011–1018CrossRef
9.
Zurück zum Zitat Watanabe S, Amiya E, Watanabe M, Takata M, Ozeki A, Watanabe A, Kawarasaki S, Nakao T, Hosoya Y, Omori K, Maemura K, Komuro I, Nagai R (2013) Simultaneous heart rate variability monitoring enhances the predictive value of flow-mediated dilation in ischemic heart disease. Circ J 77(4):1018–1258CrossRef Watanabe S, Amiya E, Watanabe M, Takata M, Ozeki A, Watanabe A, Kawarasaki S, Nakao T, Hosoya Y, Omori K, Maemura K, Komuro I, Nagai R (2013) Simultaneous heart rate variability monitoring enhances the predictive value of flow-mediated dilation in ischemic heart disease. Circ J 77(4):1018–1258CrossRef
10.
Zurück zum Zitat Johnson HM, Gossett LK, Piper ME, Aeschlimann SE, Korcarz CE, Baker TB, Fiore MC, Stein JH (2010) Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial. J Am Coll Cardiol 55(18):1988–1995CrossRef Johnson HM, Gossett LK, Piper ME, Aeschlimann SE, Korcarz CE, Baker TB, Fiore MC, Stein JH (2010) Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial. J Am Coll Cardiol 55(18):1988–1995CrossRef
11.
Zurück zum Zitat Diehl P, Aleker M, Helbing T, Sossong V, Beyersdorf F, Olschewski M, Bode C, Moser M (2010) Enhanced microparticles in ventricular assist device patients predict platelet, leukocyte and endothelial cell activation. Interact Cardiovasc Thorac Surg 11(2):133–137CrossRef Diehl P, Aleker M, Helbing T, Sossong V, Beyersdorf F, Olschewski M, Bode C, Moser M (2010) Enhanced microparticles in ventricular assist device patients predict platelet, leukocyte and endothelial cell activation. Interact Cardiovasc Thorac Surg 11(2):133–137CrossRef
12.
Zurück zum Zitat Sansone R, Stanske B, Keymel S, Schuler D, Horn P, Saeed D, Boeken U, Westenfeld R, Lichtenberg A, Kelm M, Heiss C (2015) Macrovascular and microvascular function after implantation of left ventricular assist devices in end-stage heart failure: role of microparticles. J Heart Lung Transplant 34:921–932CrossRef Sansone R, Stanske B, Keymel S, Schuler D, Horn P, Saeed D, Boeken U, Westenfeld R, Lichtenberg A, Kelm M, Heiss C (2015) Macrovascular and microvascular function after implantation of left ventricular assist devices in end-stage heart failure: role of microparticles. J Heart Lung Transplant 34:921–932CrossRef
13.
Zurück zum Zitat Hasin T, Matsuzawa Y, Guddeti RR, Aoki T, Kwon TG, Schettle S, Lennon RJ, Chokka RG, Lerman A, Kushwaha SS (2015) Attenuation in peripheral endothelial function after continuous flow left ventricular assist device therapy is associated with cardiovascular adverse events. Circ J 79:770–777CrossRef Hasin T, Matsuzawa Y, Guddeti RR, Aoki T, Kwon TG, Schettle S, Lennon RJ, Chokka RG, Lerman A, Kushwaha SS (2015) Attenuation in peripheral endothelial function after continuous flow left ventricular assist device therapy is associated with cardiovascular adverse events. Circ J 79:770–777CrossRef
14.
Zurück zum Zitat Minneci PC, Deans KJ, Zhi H, Yuen PS, Star RA, Banks SM, Schechter AN, Natanson C, Gladwin MT, Solomon SB (2005) Hemolysis-associated endothelial dysfunction mediated by accelerated NO inactivation by decompartmentalized oxyhemoglobin. J Clin Invest 115(12):3409–3417CrossRef Minneci PC, Deans KJ, Zhi H, Yuen PS, Star RA, Banks SM, Schechter AN, Natanson C, Gladwin MT, Solomon SB (2005) Hemolysis-associated endothelial dysfunction mediated by accelerated NO inactivation by decompartmentalized oxyhemoglobin. J Clin Invest 115(12):3409–3417CrossRef
15.
Zurück zum Zitat Caruso R, Verde A, Campolo J, Milazzo F, Russo C, Boroni C, Parolini M, Trunfio S, Paino R, Martinelli L, Frigerio M, Parodi O (2012) Severity of oxidative stress and inflammatory activation in end-stage heart failure patients are unaltered after 1 month of left ventricular mechanical assistance. Cytokine 59:138–144CrossRef Caruso R, Verde A, Campolo J, Milazzo F, Russo C, Boroni C, Parolini M, Trunfio S, Paino R, Martinelli L, Frigerio M, Parodi O (2012) Severity of oxidative stress and inflammatory activation in end-stage heart failure patients are unaltered after 1 month of left ventricular mechanical assistance. Cytokine 59:138–144CrossRef
16.
Zurück zum Zitat Zhang C (2008) The role of inflammatory cytokines in endothelial dysfunction. Basic Res Cardiol 103:398–406CrossRef Zhang C (2008) The role of inflammatory cytokines in endothelial dysfunction. Basic Res Cardiol 103:398–406CrossRef
17.
Zurück zum Zitat Imamura T, Murasawa T, Kawasaki H, Kashiwa K, Kinoshita O, Nawata K, Ono M (2017) Correlation between driveline features and driveline infection in left ventricular assist device selection. J Artif Organs 20(1):34–41CrossRef Imamura T, Murasawa T, Kawasaki H, Kashiwa K, Kinoshita O, Nawata K, Ono M (2017) Correlation between driveline features and driveline infection in left ventricular assist device selection. J Artif Organs 20(1):34–41CrossRef
Metadaten
Titel
Significant impact of left ventricular assist device models on the value of flow-mediated dilation: effects of LVAD on endothelial function
verfasst von
Aya Watanabe
Eisuke Amiya
Masaru Hatano
Masafumi Watanabe
Atsuko Ozeki
Daisuke Nitta
Hisataka Maki
Yumiko Hosoya
Masaki Tsuji
Chie Bujo
Akihito Saito
Miyoko Endo
Yukie Kagami
Mariko Nemoto
Kan Nawata
Osamu Kinoshita
Mitsutoshi Kimura
Minoru Ono
Issei Komuro
Publikationsdatum
20.07.2019
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 2/2020
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-019-01474-2

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