Characteristics and outcome of ambulatory heart failure patients receiving a left ventricular assist device

Autor: Baudry, Guillaume, Nesseler, Nicolas, Flecher, Erwan, Vincentelli, André, Goeminne, Céline, Delmas, Clément, Porterie, Jean, Nubret, Karine, Pernot, Mathieu, Kindo, Michel, Hoang Minh, Tam, Rouvière, Philippe, Gaudard, Philippe, Michel, Magali, Senage, Thomas, Boignard, Aude, Chavanon, Olivier, Para, Marylou, Verdonk, Constance, Pelcé, Edeline, Gariboldi, Vlad, Anselme, Frederic, Litzler, Pierre‐Yves, Blanchart, Katrien, Babatasi, Gerard, Bielefeld, Marie, Bouchot, Olivier, Hamon, David, Lellouche, Nicolas, Bailleul, Xavier, Genet, Thibaud, Eschalier, Romain, d'Ostrevy, Nicolas, Bories, Marie‐Cécile, Akar, Ramzi Abi, Blangy, Hugues, Vanhuyse, Fabrice, Obadia, Jean François, Galand, Vincent, Pozzi, Matteo
Přispěvatelé: Hospices Civils de Lyon (HCL), Hôpital Louis Pradel [CHU - HCL], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Université de Bordeaux Ségalen [Bordeaux 2], Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Charles Nicolle [Rouen], Université de Caen Normandie (UNICAEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Henri Mondor, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire de Nancy (CHU Nancy), Hôpital Brabois, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Rouen, Normandie Université (NU)-Normandie Université (NU), CHU Henri Mondor [Créteil], The authors received no financial support for the research, authorship, and/or publication of this article., MORNET, Dominique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: ESC Heart Failure
ESC Heart Failure, Wiley, 2021, Online ahead of print. ⟨10.1002/ehf2.13592⟩
ESC Heart Failure, 2021, 8 (6), pp.5159-5167. ⟨10.1002/ehf2.13592⟩
ESC Heart Failure, Vol 8, Iss 6, Pp 5159-5167 (2021)
ISSN: 2055-5822
DOI: 10.1002/ehf2.13592⟩
Popis: International audience; Aims: Despite regularly updated guidelines, there is still a delay in referral of advanced heart failure patients to mechanical circulatory support and transplant centres. We aimed to analyse characteristics and outcome of non-inotrope-dependent patients implanted with a left ventricular assist device (LVAD).Methods and results: The ASSIST-ICD registry collected LVAD data in 19 centres in France between February 2006 and December 2016. We used data of patients in Interagency Registry for Mechanically Assisted Circulatory Support Classes 4-7. The primary endpoint was survival analysis. Predictors of mortality were searched with multivariable analyses. A total of 303 patients (mean age 61.0 ± 9.9 years, male sex 86.8%) were included in the present analysis. Ischaemic cardiomyopathy was the leading heart failure aetiology (64%), and bridge to transplantation was the main implantation strategy (56.1%). The overall likelihood of being alive while on LVAD support or having a transplant at 1, 2, 3, and 5 years was 66%, 61.7%, 58.7%, and 55.1%, respectively. Age [hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.00-1.05; P = 0.02], a concomitant procedure (HR 2.32, 95% CI 1.52-3.53; P < 0.0001), and temporary mechanical right ventricular support during LVAD implantation (HR 2.94, 95% CI 1.49-5.77; P = 0.002) were the only independent variables associated with mortality. Heart failure medications before or after LVAD implantation were not associated with survival.Conclusion: Ambulatory heart failure patients displayed unsatisfactory survival rates after LVAD implantation. A better selection of patients who can benefit from LVAD may help improving outcomes.
Databáze: OpenAIRE
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