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Young patients with nonischemic cardiomyopathy have higher likelihood of left ventricular recovery during left ventricular assist device support.

Abstract：

BACKGROUND:Recovery of ventricular function during left ventricular assist device (LVAD) support allowing device explantation occurs infrequently. We explored the hypothesis that certain patient profiles are more likely to exhibit LV recovery during LVAD support. METHODS AND RESULTS:A retrospective analysis of data from the HeartMate II bridge to transplant (BTT) and destination therapy (DT) trials was conducted, including 490 BTT, 600 DT, and 18 compassionate-use patients. Of the 1,108 patients, 20 (1.8%; 10 BTT, 10 DT) were explanted owing to LV recovery. The median age was 33 years, and 12 patients (60%) were <40 years of age. History of heart failure was <1 year for 11 patients (61%), and the primary etiology was nonischemic (90%). Of the patients with nonischemic etiologies and <1-year history of heart failure, 13% were explanted. Three patients required LVAD reimplantation; of the remaining 17, 16 remain alive. At follow-up (median 510 days), the mean ejection fraction was 42% (20%-67%) and the mean left ventricular end-diastolic diameter was 55 ± 8 mm. At the 2-year follow-up (n = 13), patients were New York Heart Association functional class I or II and overall survival rate was 85 ± 11%. CONCLUSIONS:The results of this study suggest that LV recovery is most likely to occur in young patients (<40 years) with nonischemic cardiomyopathy of <1 year duration. Two-year postexplant survival was excellent.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Goldstein DJ,Maybaum S,MacGillivray TE,Moore SA,Bogaev R,Farrar DJ,Frazier OH,HeartMate II Clinical Investigators.

doi

10.1016/j.cardfail.2012.01.020

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

392-5

issue

5

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(12)00043-7

journal_volume

18

pub_type

杂志文章,多中心研究,随机对照试验

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