| Autor: |
Kavitha Muthiah, MBChB, PhD, FRACP, FCSANZ, Louise L. Dunn, BSc(Hons), PhD, Hunter Eckford, BMedSci, David Connor, BMedSci(Hons), PhD, Desiree Robson, RN, Peter S. Macdonald, MBBS, FRACP, MD, PhD, Christopher S. Hayward, MD, FRACP |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
JHLT Open, Vol 6, Iss , Pp 100133- (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2950-1334 |
| DOI: |
10.1016/j.jhlto.2024.100133 |
| Popis: |
Bleeding complications are a bane of continuous flow left ventricular assist devices (cfLVAD); gastrointestinal bleeding (GIB) from arteriovenous malformation (AVM) predominating. We hypothesized that shear stress disrupts vascular endothelium altering angiogenesis and contributing to bleeding. We profiled markers of endothelial dysfunction (soluble thrombomodulin [sTM]) and angiogenesis (angiopoietin-1 [Ang-1], angiopoietin-2 [Ang-2]) in 21 patients implanted with a centrifugal cfLVAD. Bleeding episodes were documented in 11 patients, 8 had GIB, 4 of whom had AVMs. We observed a dynamic change in sTM and Ang-2/Ang-1 ratio following cfLVAD support (p = 0.030 and p = 0.025, respectively). Bleeding patients had higher sTM and Ang-2/Ang-1 ratios than patients with no bleeding (p = 0.04 and p = 0.06, respectively). At D180, patients with AVMs had significantly higher Ang-2/Ang-1 ratios vs patients without proven AVMs (p = 0.006). We conclude that bleeding in cfLVAD-supported patients is associated with alteration in endothelial/vascular homeostasis, possibly contributing to AVM formation. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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