Endocrine function is not impaired in patients with a continuous MicroMed-DeBakey axial flow pump.
OBJECTIVE
Pulsatile blood flow has been regarded to be of importance for the regulation of endocrine organs. A new generation of continuous flow mechanical blood pumps is now available for clinical application. Patients with implanted MicroMed-DeBakey axial pumps show nonphysiologic low-pulsatile blood flow profiles, and therefore it appeared to be of interest to evaluate their possible effect on the endocrine system.


METHODS
Eight male patients and 1 female patients (mean age, 51 +/- 10 years) with end-stage left-sided heart failure were implanted with a MicroMed-DeBakey axial pump. After a mean period of 67 +/- 19 days, basal pituitary hormone concentrations and their responses to a bolus injection of hypothalamic releasing hormones were tested. In addition, thyroid hormones, testosterone, and plasma and urinary catecholamine levels were measured at baseline.


RESULTS
Administration of the hypothalamic releasing hormones revealed normal responses of all pituitary hormones (adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone, and prolactin), except for growth hormone, the response of which was slightly impaired (10.2 +/- 6.8 vs 19.9 +/- 6.5 ng/L, P < .05). Also, the cortisol response to the corticotropin-releasing hormone-stimulated adrenocorticotropic hormone release was normal, as were basal concentrations of thyroid hormones (triiodothyronine, thyroxine, free triiodothyronine, and free thyroxine), testosterone, and urinary catecholamines.


CONCLUSIONS
Implantation of a continuous flow axial pump with low-pulsatile blood flow profile appears to have no major effect on the hypothalamic-pituitary-endorgan system and sympathoadrenal functions. This finding is reassuring for the growing number of patients treated with this convenient new pump and could contribute considerably to their prognosis and quality of life.
Wieselthaler
Georg M
GM
Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria.
Riedl
Michaela
M
Schima
Heinrich
H
Wagner
Oswald
O
Waldhäusl
Werner
W
Wolner
Ernst
E
Luger
Anton
A
Clodi
Martin
M
D002395:Catecholamines / Q000652:urine; D003346:Corticotropin-Releasing Hormone; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010906:Pituitary Hormone-Releasing Hormones; D010907:Pituitary Hormones / Q000378:metabolism; D011673:Pulsatile Flow; D013739:Testosterone / Q000378:metabolism; D013963:Thyroid Hormones / Q000378:metabolism
D002395:Catecholamines; D006728:Hormones; D010906:Pituitary Hormone-Releasing Hormones; D010907:Pituitary Hormones; D013963:Thyroid Hormones; D013739:Testosterone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone