Impact of cardiac fibrosis and collagens on right ventricular failure and acute kidney injury in patients after continuous-flow left ventricular assist devices
| Autor: | Hong-Tao Tie, Henryk Welp, Sven Martens, Sabrina Martens, Zhenhan Li, Martina Seiler, Klaus-Michael Mueller, Petra Albers |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Cardiac fibrosis medicine.medical_treatment Ventricular Dysfunction Right Renal function 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Humans In patient 030212 general & internal medicine Renal replacement therapy Retrospective Studies Mechanical ventilation Heart Failure Continuous flow business.industry Acute kidney injury Mechanical Circulatory Support Acute Kidney Injury medicine.disease Intensive care unit Fibrosis Right Ventricular Assist Device Ventricular assist device Cardiology Right ventricular failure Surgery Collagen Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interact Cardiovasc Thorac Surg |
| Popis: | OBJECTIVES We aim to investigate the impact of cardiac fibrosis and collagens on right ventricular failure (RVF) and acute kidney injury (AKI) in patients receiving continuous flow left ventricular assist devices. METHODS Heart tissues from 34 patients were obtained from continuous flow left ventricular assist device insertion sites and corresponding clinical data were collected. The participants were divided into 2 groups according to the extent of the cardiac fibrosis or collagens. RESULTS Overall, 18 patients developed RVF with 14 receiving right ventricular assist device (RVAD), and 22 patients developed AKI with 12 needing new-onset renal replacement therapy. Higher collagen I (Col1) was significantly associated with increased incidences of RVF (76.5% vs 29.4%, P = 0.015), RVAD support (64.7% vs 17.6%, P = 0.013) and stage 3 AKI (58.8% vs 17.6%, P = 0.032), and patients with higher Col1 were more prone to renal replacement therapy (52.9% vs 17.6%, P = 0.071). Receiver operating characteristic curves showed that Col1 had good predictive effects on RVF [area under the curve (AUC) = 0.806, P = 0.002], RVAD support (AUC = 0.789, P = 0.005), stage 3 AKI (AUC = 0.740, P = 0.020) and renal replacement therapy (AUC = 0.731, P = 0.028) after continuous-flow left ventricular assist device. Moreover, patients with higher Col1 had significantly longer postoperative duration of mechanical ventilation, duration of intensive care unit stay and hospital length of stay (all P CONCLUSIONS Cardiac fibrosis and related collagens in the apical left ventricular tissue are associated with increased risks of RVF, RVAD use and worse renal function. Further study is warranted owing to the small sample size. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|