TY - JOUR
T1 - Serum Brain Natriuretic Peptide Concentration 60 Days after Surgery as a Predictor of Long-Term Prognosis in Patients Implanted with a Left Ventricular Assist Device
AU - Sato, Takuma
AU - Seguchi, Osamu
AU - Iwashima, Yoshio
AU - Yanase, Masanobu
AU - Nakajima, Seiko
AU - Hieda, Michinari
AU - Watanabe, Takuya
AU - Sunami, Haruki
AU - Murata, Yoshihiro
AU - Hata, Hiroki
AU - Fujita, Tomoyuki
AU - Kobayashi, Junjiro
AU - Nakatani, Takeshi
N1 - Publisher Copyright:
© American Society of Artificial Internal Organs.
PY - 2015/7/21
Y1 - 2015/7/21
N2 - Mechanical circulatory support by a left ventricular assist device (LVAD) is used to bridge patients with advanced heart failure to transplant or as a definitive treatment. We retrospectively sought predictors of long-term outcome in a cohort of 83 patients who had undergone LVAD treatment. We subjected perioperative clinical data of patients to statistical analysis to establish parameters associated with all-cause mortality, and the cutoff values, sensitivity, and specificity of those that had a statistically significant relation with survival. Mean follow-up was 717 days (standard deviation, 334 days; range, 17-1,592 days). Fourteen patients (16.8%) died, but nine (10.8%) were weaned from support. Serum brain natriuretic peptide (BNP) concentration measured 60 days after implantation was significantly associated with all-cause mortality. The optimal BNP cutoff value to predict death during LVAD support was 322 pg/ml, with a sensitivity of 71.4% and specificity of 79.8%. Two-year survival was 92.0% in those with 60 days serum BNP concentration <322 pg/ml compared with 70.5% in those in whom it was ≥322 pg/ml (p = 0.003). The relation between BNP and survival likely reflects recovery of native myocardial function and improvements in global health and should assist clinicians in the on-going management of long-term LVAD therapy.
AB - Mechanical circulatory support by a left ventricular assist device (LVAD) is used to bridge patients with advanced heart failure to transplant or as a definitive treatment. We retrospectively sought predictors of long-term outcome in a cohort of 83 patients who had undergone LVAD treatment. We subjected perioperative clinical data of patients to statistical analysis to establish parameters associated with all-cause mortality, and the cutoff values, sensitivity, and specificity of those that had a statistically significant relation with survival. Mean follow-up was 717 days (standard deviation, 334 days; range, 17-1,592 days). Fourteen patients (16.8%) died, but nine (10.8%) were weaned from support. Serum brain natriuretic peptide (BNP) concentration measured 60 days after implantation was significantly associated with all-cause mortality. The optimal BNP cutoff value to predict death during LVAD support was 322 pg/ml, with a sensitivity of 71.4% and specificity of 79.8%. Two-year survival was 92.0% in those with 60 days serum BNP concentration <322 pg/ml compared with 70.5% in those in whom it was ≥322 pg/ml (p = 0.003). The relation between BNP and survival likely reflects recovery of native myocardial function and improvements in global health and should assist clinicians in the on-going management of long-term LVAD therapy.
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U2 - 10.1097/MAT.0000000000000234
DO - 10.1097/MAT.0000000000000234
M3 - Article
C2 - 26120957
AN - SCOPUS:84937568855
SN - 1058-2916
VL - 61
SP - 373
EP - 378
JO - ASAIO Journal
JF - ASAIO Journal
IS - 4
ER -