AI Article Synopsis

  • A significant number of heart failure patients progress to advanced stages, which heightens health risks, and some may qualify for advanced treatments like ventricular assist devices (VAD).
  • This study assessed vascular function in 34 patients with VAD compared to 34 patients with advanced heart failure, finding that those with VAD showed improved endothelial function in larger arteries but not in microcirculation.
  • The findings suggest that while VAD implantation benefits endothelial function at the arterial level, it does not enhance microvascular function in advanced heart failure patients.

Article Abstract

Background: A significant proportion of patients with heart failure (HF) progress to an advanced stage, which is associated with a substantial increase in morbidity and mortality. These patients may be eligible for advanced treatment strategies such as mechanical circulatory support with ventricular assist devices (VAD). Vascular dysfunction is a hallmark of heart failure pathophysiology and prognosis. However, whether and to what degree the hemodynamic benefits of VADs influence vascular function remain unknown.

Methods And Results: In this study, we evaluated endothelial vascular function with flow-mediated vasodilatation (FMD) and with flicker-light induced retinal vasodilatation (FID). 34 patients with a VAD (age 58 ± 10 years, 85% male, 74% ischemic heart disease, 26 continuous-flow (CF)-LVAD, and 8 pulsatile biventricular (bi)-VAD) were compared to 34 propensity-matched patients (mean age 62 ± 9 years, 68% male, 59% ischemic heart disease) with advanced HF (AdvHF). Endothelial function of larger arteries (FMD) was significantly better in patients after VAD implantation compared to matched AdvHF patients (7.2 ± 4.6% vs. 5.0 ± 3.2%, p = 0.03), whereas microvascular arteriolar function (FIDart) did not differ (0.99 ± 1.43% vs. 1.1 ± 1.7%, p = 0.78). The arterio-venous ratio (AVR) was higher in the VAD group (0.90 ± 0.06 vs 0.85 ± 0.09, p = 0.01), reflecting wider retinal arteriolar and narrower venular diameters. There was no difference in vascular function between patients with CF-LVAD and pulsatile Bi-VAD.

Conclusion: In patients with advanced heart failure, VAD implantation was associated with better endothelial function at the level of large arteries, but not in the microcirculation.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00392-024-02519-xDOI Listing

Publication Analysis

Top Keywords

vascular function
16
heart failure
16
patients
9
function patients
8
patients advanced
8
advanced heart
8
ventricular assist
8
assist devices
8
patients vad
8
ischemic heart
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!