Effect of Continuous-Flow Left Ventricular Assist Device Support on Coronary Artery Endothelial Function in Ischemic and Nonischemic Cardiomyopathy.

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Tytuł:: Effect of Continuous-Flow Left Ventricular Assist Device Support on Coronary Artery Endothelial Function in Ischemic and Nonischemic Cardiomyopathy.
Autorzy:: Symons JD; Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City (J.D.S., L.D., N.D., T.B., J.M.C., S.G.D.).; Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes (J.D.S.), University of Utah, Salt Lake City.; Molecular Medicine Program (J.D.S., P.F., L.M., N.A.D., I.T., S.N., S.G.D.), University of Utah, Salt Lake City.
Deeter L; Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City (J.D.S., L.D., N.D., T.B., J.M.C., S.G.D.).
Deeter N; Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City (J.D.S., L.D., N.D., T.B., J.M.C., S.G.D.).
Bonn T; Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City (J.D.S., L.D., N.D., T.B., J.M.C., S.G.D.).
Cho JM; Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City (J.D.S., L.D., N.D., T.B., J.M.C., S.G.D.).
Ferrin P; Molecular Medicine Program (J.D.S., P.F., L.M., N.A.D., I.T., S.N., S.G.D.), University of Utah, Salt Lake City.; Nora Eccles Harrison Cardiovascular Research and Training Institute (P.F., L.M., N.A.D., I.T., S.N., C.H.S., S.G.D.), University of Utah, Salt Lake City.
McCreath L; Molecular Medicine Program (J.D.S., P.F., L.M., N.A.D., I.T., S.N., S.G.D.), University of Utah, Salt Lake City.; Nora Eccles Harrison Cardiovascular Research and Training Institute (P.F., L.M., N.A.D., I.T., S.N., C.H.S., S.G.D.), University of Utah, Salt Lake City.
Diakos NA; Molecular Medicine Program (J.D.S., P.F., L.M., N.A.D., I.T., S.N., S.G.D.), University of Utah, Salt Lake City.; Nora Eccles Harrison Cardiovascular Research and Training Institute (P.F., L.M., N.A.D., I.T., S.N., C.H.S., S.G.D.), University of Utah, Salt Lake City.
Taleb I; Molecular Medicine Program (J.D.S., P.F., L.M., N.A.D., I.T., S.N., S.G.D.), University of Utah, Salt Lake City.; Nora Eccles Harrison Cardiovascular Research and Training Institute (P.F., L.M., N.A.D., I.T., S.N., C.H.S., S.G.D.), University of Utah, Salt Lake City.; UTAH Cardiac Transplant Program, Intermountain Medical Center, Salt Lake VA Medical Center (I.T., R.A., S.M., O.W.-P., C.H.S., J.C.F., S.G.D.), University of Utah, Salt Lake City.
Alharethi R; UTAH Cardiac Transplant Program, Intermountain Medical Center, Salt Lake VA Medical Center (I.T., R.A., S.M., O.W.-P., C.H.S., J.C.F., S.G.D.), University of Utah, Salt Lake City.
McKellar S; UTAH Cardiac Transplant Program, Intermountain Medical Center, Salt Lake VA Medical Center (I.T., R.A., S.M., O.W.-P., C.H.S., J.C.F., S.G.D.), University of Utah, Salt Lake City.
Wever-Pinzon O; UTAH Cardiac Transplant Program, Intermountain Medical Center, Salt Lake VA Medical Center (I.T., R.A., S.M., O.W.-P., C.H.S., J.C.F., S.G.D.), University of Utah, Salt Lake City.
Navankasattusas S; Molecular Medicine Program (J.D.S., P.F., L.M., N.A.D., I.T., S.N., S.G.D.), University of Utah, Salt Lake City.; Nora Eccles Harrison Cardiovascular Research and Training Institute (P.F., L.M., N.A.D., I.T., S.N., C.H.S., S.G.D.), University of Utah, Salt Lake City.
Selzman CH; Nora Eccles Harrison Cardiovascular Research and Training Institute (P.F., L.M., N.A.D., I.T., S.N., C.H.S., S.G.D.), University of Utah, Salt Lake City.; UTAH Cardiac Transplant Program, Intermountain Medical Center, Salt Lake VA Medical Center (I.T., R.A., S.M., O.W.-P., C.H.S., J.C.F., S.G.D.), University of Utah, Salt Lake City.
Fang JC; UTAH Cardiac Transplant Program, Intermountain Medical Center, Salt Lake VA Medical Center (I.T., R.A., S.M., O.W.-P., C.H.S., J.C.F., S.G.D.), University of Utah, Salt Lake City.
Drakos SG; Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City (J.D.S., L.D., N.D., T.B., J.M.C., S.G.D.).; Molecular Medicine Program (J.D.S., P.F., L.M., N.A.D., I.T., S.N., S.G.D.), University of Utah, Salt Lake City.; Nora Eccles Harrison Cardiovascular Research and Training Institute (P.F., L.M., N.A.D., I.T., S.N., C.H.S., S.G.D.), University of Utah, Salt Lake City.; UTAH Cardiac Transplant Program, Intermountain Medical Center, Salt Lake VA Medical Center (I.T., R.A., S.M., O.W.-P., C.H.S., J.C.F., S.G.D.), University of Utah, Salt Lake City.
Źródło:: Circulation. Heart failure [Circ Heart Fail] 2019 Aug; Vol. 12 (8), pp. e006085. Date of Electronic Publication: 2019 Aug 19.
Typ publikacji:: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins
MeSH Terms:: Heart-Assist Devices*
Cardiomyopathies/*complications
Coronary Vessels/*physiopathology
Endothelium, Vascular/*physiopathology
Heart Failure/*therapy
Myocardial Ischemia/*complications
Vasodilation/*physiology
Biopsy ; Cardiomyopathies/physiopathology ; Cardiomyopathies/therapy ; Coronary Vessels/pathology ; Echocardiography ; Female ; Follow-Up Studies ; Heart Failure/diagnosis ; Heart Failure/physiopathology ; Humans ; Male ; Middle Aged ; Myocardial Ischemia/physiopathology ; Myocardial Ischemia/therapy ; Myocardium/pathology
Grant Information:: R01 HL141540 United States HL NHLBI NIH HHS; R03 AG052848 United States AG NIA NIH HHS
Contributed Indexing:: Keywords: arteries; endothelium; heart; heart failure; left ventricular assist device
Entry Date(s):: Date Created: 20190820 Date Completed: 20200511 Latest Revision: 20221007
Update Code:: 20240105
DOI:: 10.1161/CIRCHEARTFAILURE.119.006085
PMID:: 31422672
: Czasopismo naukowe

Background: The coronary vasculature encounters a reduction in pulsatility after implementing durable continuous-flow left ventricular assist device (CF-LVAD) circulatory support. Evidence exists that appropriate pulsatility is required to maintain endothelial cell homeostasis. We hypothesized that coronary artery endothelial function would be impaired after CF-LVAD intervention.
Methods and Results: Coronary arteries from patients with end-stage heart failure caused by ischemic cardiomyopathy (ICM; n=16) or non-ICM (n=22) cardiomyopathy were isolated from the left ventricular apical core, which was removed for the CF-LVAD implantation. In 11 of these patients, paired coronary arteries were obtained from an adjacent region of myocardium after the CF-LVAD intervention (n=6 ICM, 5 non-ICM). Vascular function was assessed ex vivo using isometric tension procedures in these patients and in 7 nonfailing donor controls. Maximal endothelium-dependent vasorelaxation to BK (bradykinin; 10 - 6 -10 - 10 M) was blunted (P<0.05) in arteries from patients with ICM compared with non-ICM and donor controls, whereas responses to sodium nitroprusside (10 -4 -10 -9 M) were similar among the groups. Contrary to our hypothesis, vasorelaxation responses to BK and sodium nitroprusside were similar before and 219±37 days after CF-LVAD support. Of these patients, an exploratory subgroup analysis revealed that BK-induced coronary artery vasorelaxation was greater (P<0.05) after (87±6%) versus before (54±14%) CF-LVAD intervention in ICM patients, whereas sodium nitroprusside-evoked responses were similar.
Conclusions: Coronary artery endothelial function is not impaired by durable CF-LVAD support and in ICM patients appears to be improved. Investigating coronary endothelial function using in vivo approaches in a larger patient population is warranted.

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