Predictors of Physical Capacity 6 Months After Implantation of a Full Magnetically Levitated Left Ventricular Assist Device: An Analysis From the ELEVATE Registry
| Autor: | Jerry Heatley, Yuri Pya, Finn Gustafsson, Anno Diegeler, Elevate investigators, Kiran K Mirza, Ivan Netuka, Jacob Lavee, Diyar Saeed, Jens Garbade, Steven M. Shaw, Michiel Morshuis, Evgenij V. Potapov, Jan D. Schmitto, Daniel Zimpfer |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030204 cardiovascular system & hematology Independent predictor 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine In patient 6-minute walk test Registries 030212 general & internal medicine Aged Heart Failure business.industry Atrial fibrillation medicine.disease Treatment Outcome Diabetes Mellitus Type 2 Physical performance Walk test Heart failure Ventricular assist device Cardiology Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiac Failure. 26:580-587 |
| ISSN: | 1071-9164 |
| DOI: | 10.1016/j.cardfail.2020.04.004 |
| Popis: | In patients with a continuous-flow left ventricular assist device, preimplant predictors of poor physical performance are not well-described. We aimed to identify predictors of inability to walk more than 300 m on 6-minute walk test (6MWT) 6 months after HeartMate 3 implantation.Using data from the European Registry of Patients Implanted With a Full Magnetically Levitated LVAD, patients with available 6MWT at 6 months after implantation were included (N = 194) and grouped according to 6MWT distance (6MWD) of300 m (n = 150) or 6MWD of300 m (n = 44). Patients walking300 m were older (60 ± 10 vs 52 ± 12 years; P.001), more often New York Heart Association functional class IV (63% vs 42%; P = .03), and more often had type 2 diabetes (43% vs 17%; P.001) at implantation. Atrial fibrillation was seen in 57% in those with a 6MWT of300 m vs 31% in those walking longer (P.002). Further, hemoglobin and estimated glomerular filtration rate was lower in those walking300 m (both P.01). In multivariable regression analysis, independent predictors of a 6MWD of300 m were: atrial fibrillation (odds ratio [OR], 3.22; 95% confidence interval [CI], 1.12-8.67), older age (OR for 10-year increment, 2.81; 95% CI, 1.55-5.07), New York Heart Association functional class IV (OR, 3.37; 95% CI, 1.27-8.98), and Interagency Registry for Mechanically Assisted Circulatory Support profile 1 or 2 (OR, 6.53; 95% CI, 1.92-22.19).Six months after HeartMate 3 implantation, 77% of patients walked300 meters in 6 minutes. Apart from age and measures of heart failure severity, atrial fibrillation at implantation is an independent predictor of low 6MWD at 6 months after implantation. |
| Databáze: | OpenAIRE |
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