Neurohormone levels remain elevated in continuous flow left ventricular assist device recipients

Abstract

The findings that aldosterone, norepinephrine, and renin were elevated after restoration of hemodynamic functions during LVAD support suggest that the levels of neurohormones did not normalize. Future studies should investigate whether AV status in CF-LVAD recipients affects the levels of RAAS neurohormones and the mechanisms and clinical implications of elevated levels of neurohormones in CF-LVAD patients.

Sympathetic Markers are Different Between Clinical Responders and Nonresponders After Left Ventricular Assist Device Implantation

“…32 Grosman-Rimon et al recently demonstrated that NE levels remain elevated after implantation of a continuous flow LVAD and are similar to HF controls. 27 We have taken this one-step further and showed that while over activation of the sympathetic nervous system persists post-LVAD, there is a different sympathetic profile between clinical responders and non-responders, using a patient-reported outcome metric. Our findings show that there is a graded difference in sympathetic dysregulation, which may help to pinpoint one potential mechanism underlying stagnantly poor HRQOL post-LVAD.…”

“…Uric acid was undetectable and recoveries of both NE and DHPG in the plasma samples were adequate using this method. 25 The potential range of plasma NE is dependent on the assay method, but generally averages about 0.5-3 pmol/mL; 18,27 plasma DHPG is about 5-6 times higher than plasma NE. 18 In each of the assays, we also included samples of de-identified pooled plasma stored from healthy volunteers as a comparison.…”

Changes in Von Willebrand factor profile predicts clinical outcomes in patients on mechanical circulatory support

“…This may be responsible for an increase in vWF:Ag and vWF:NT‐pro concentrations . Moreover, catecholamines increase vWF secretion in endothelial cells and it has been shown that neurohormone levels remain elevated prior to and following cf‐LVAD implantation …”

Clinical myocardial recovery in advanced heart failure with long term left ventricular assist device support

“…There are sparse data that compares biomarker levels in recovered versus non-recovered LVAD patients. Examples of biomarkers studied in LVAD patients include markers of myocardial stretch (BNP or NT-proBNP), 34,57 neurohormones, 58 mediators of inflammatory and fibrotic responses (CRP, sST2, TNFa, IFNg, IL6), 34,59,60 and microRNAs. 61,62…”