Preoperative beta-blocker treatment is a key for deciding left ventricular assist device implantation strategy as a bridge to recovery

Teruhiko Imamura, Koichiro Kinugawa, Masaru Hatano, Takeo Fujino, Hironori Muraoka, Toshiro Inaba, Hisataka Maki, Yukie Kagami, Miyoko Endo, Osamu Kinoshita, Kan Nawata, Shunei Kyo, Minoru Ono

研究成果: Contribution to journalArticle査読

25 被引用数 (Scopus)

抄録

To date, there have been few reports demonstrating preoperative predictors for left ventricular reverse remodeling (LVRR) after LV assist device (LVAD) implantation, especially among patients with dilated cardiomyopathy (DCM). We retrospectively analyzed 60 patients with stage D heart failure due to DCM who had received LVAD treatment [pulsatile flow (PF) type, 26; continuous flow type, 34]. Data were evaluated at 6 months or just before explantation of the LVAD. We defined "LV reverse remodeling" (LVRR) by the achievement of an LV ejection fraction (LVEF) of ≥35% after 6 months of LVAD support or explantation of LVAD within 6 months. LVRR occurred in 16 of our patients (26.7 %). Uni/multivariate logistic regression analyses for LVRR demonstrated that of the preoperative variables evaluated, PF LVAD usage and insufficient preoperative β-blocker treatment were independent predictors for LVRR. Patients who accomplished LVRR had a better clinical course, including lower levels of aortic valve insufficiency and lower levels of plasma B-type natriuretic peptide. Of the six patients (10.0 %) in whom LVADs were eventually explanted, all had an LVEF of ≥35 % before explantation or at 6 months. Based on these results, we conclude that DCM patients with insufficient preoperative β-blocker treatment have a chance to achieve LVRR under LVAD support as a bridge to recovery.

本文言語英語
ページ(範囲)23-32
ページ数10
ジャーナルJournal of Artificial Organs
17
1
DOI
出版ステータス出版済み - 3 2014

All Science Journal Classification (ASJC) codes

  • 医学(その他)
  • 生体材料
  • 生体医工学
  • 循環器および心血管医学

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