Hematologic Markers Better Predict Left Ventricular Assist Device Thrombosis than Echocardiographic or Pump Parameters
| Autor: | Amaninderapal S. Ghotra, Kelly C. McCants, Ajay Pachika, Carlo R. Bartoli, Emma J. Birks |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment chemistry.chemical_compound Internal medicine medicine Humans Retrospective Studies Heart Failure Creatinine Mitral regurgitation business.industry Repeated measures design Thrombosis Retrospective cohort study Middle Aged equipment and supplies medicine.disease chemistry Echocardiography Ventricular assist device Heart failure Cardiology Female Surgery Heart-Assist Devices Cardiology and Cardiovascular Medicine Complication business Biomarkers |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 62:414-418 |
| ISSN: | 1439-1902 0171-6425 |
| DOI: | 10.1055/s-0034-1376891 |
| Popis: | Left ventricular assist device (LVAD) thrombosis is a life-threatening complication that remains a major clinical problem. Consensus diagnostic criteria do not exist. We investigated whether hematologic, echocardiographic, or pump parameters reliably change during LVAD thrombosis.A retrospective analysis of 20 consecutive cases of continuous-flow LVAD thrombosis (Thoratec HeartMate II n = 16, HeartWare HVAD n = 4) was performed. Hematologic markers (lactate dehydrogenase, plasma-free hemoglobin, hemoglobin, creatinine), echocardiographic parameters (left ventricular end-systolic and end-diastolic diameter, mitral regurgitation, aortic insufficiency, inflow-cannula velocity), and pump characteristics (speed, power, estimated flow, pulsatility index) were analyzed with one-way repeated measures ANOVA with Tukey post-test or paired Student t-tests.Lactate dehydrogenase and plasma-free hemoglobin were significantly (p 0.05) elevated at admission for LVAD thrombosis. Hemoglobin and creatinine were not significantly different at admission but changed significantly after admission. Left ventricular end-systolic and end-diastolic diameter, mitral regurgitation, aortic insufficiency, inflow-cannula velocity, LVAD speed, power consumption, estimated flow, and pulsatility index were not significantly different at admission for LVAD thrombosis.Hematological markers of hemolysis, but not echocardiographic or pump parameters, reliably changed during LVAD thrombosis. Markers of hemolysis are the best early predictors of LVAD thrombosis. |
| Databáze: | OpenAIRE |
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