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Sympathetic Markers are Different Between Clinical Responders and Nonresponders After Left Ventricular Assist Device Implantation.
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- Author(s): Denfeld, Quin E.; Lee, Christopher S.; Woodward, William R.; Hiatt, Shirin O.; Mudd, James O.; Habecker, Beth A.
- Source:
Journal of Cardiovascular Nursing; Jul/Aug2019, Vol. 34 Issue 4, pE1-E10, 10p- Subject Terms:
SYMPATHETIC nervous system physiology; LEFT heart ventricle surgery; ADRENERGIC beta blockers; BETA adrenoceptors; BIOMARKERS; CHI-squared test; STATISTICAL correlation; ENZYME-linked immunosorbent assay; FISHER exact test; HIGH performance liquid chromatography; NORADRENALINE; QUALITY of life; QUESTIONNAIRES; T-test (Statistics); SECONDARY analysis; ETHYLENE glycols; HEART assist devices; DESCRIPTIVE statistics; MANN Whitney U Test - Source:
- Additional Information
- Abstract: Background: Clinical response to left ventricular assist devices (LVADs), as measured by health-related quality of life, varies among patients after implantation; however, it is unknown which pathophysiological mechanisms underlie differences in clinical response by health-related quality of life. Objective: The purpose of this study was to compare changes in sympathetic markers (b-adrenergic receptor kinase-1 [bARK1], norepinephrine [NE], and 3,4-dihydroxyphenylglycol [DHPG]) between health-related quality of life clinical responders and nonresponders from pre-- to post--LVAD implantation. Methods:We performed a secondary analysis on a subset of data from a cohort study of patients from pre-- to 1, 3, and 6 months after LVAD implantation. Clinical response was defined as an increase of 5 points or higher on the Kansas City Cardiomyopathy Questionnaire Clinical Summary score from pre-- to6months post--LVAD implantation.We measured plasma bARK1 level with an enzyme-linked immunosorbent assay and plasma NE and DHPG levels with high-performance liquid chromatography with electrochemical detection. Latent growth curvemodeling was used to compare the trajectories ofmarkers between groups. Results: The mean (SD) age of the sample (n = 39) was 52.9 (13.2) years, and most were male (74.4%) and received LVADs as bridge to transplantation (69.2%). Preimplantation plasma bARK1 levels were significantly higher in clinical responders (n = 19) than in nonresponders (n = 20) (P = .001), but change was similar after LVAD (P = .235). Preimplantation plasma DHPG levels were significantly lower in clinical responders than in nonresponders (P = .002), but the change was similar after LVAD (P = .881). There were no significant differences in plasma NE levels. Conclusions: Preimplantation bARK1 and DHPG levels are differentiating factors between health-related quality of life clinical responders and nonresponders to LVAD, potentially signaling differing levels of sympathetic stimulation underlying clinical response. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Journal of Cardiovascular Nursing is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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