title: Effects of continuous flow left ventricular assist device support on microvascular endothelial function.
abstract: The effects of continuous flow left ventricular assist device (CF-LVAD) support on microvascular endothelial function in New York Heart Association (NYHA) class IV heart failure (HF) patients are currently unknown. Microvascular endothelial function was assessed by beat-to-beat plethysmographic measurement of finger arterial pulse wave signal changes for 5 min following reactive hyperemia. A group of seven NYHA class IV HF patients was evaluated before CF-LVAD placement (HF), and a second group of six NYHA class IV HF patients was evaluated 1-4 months following CF-LVAD placement (CF-LVAD). Additionally, a third group of seven age-matched healthy subjects served as controls (control). There was no significant (P > 0.05) difference among the three groups in age, weight, or height. Systolic blood pressure (BP) was significantly higher in the control group (120 ± 2 mmHg) as compared to that in the HF (97 ± 8 mmHg, P = 0.005) and CF-LVAD (106 ± 4 mmHg, P = 0.003) groups. Diastolic BP was significantly lower in the HF group (57 ± 5 mmHg) as compared to that in the control (71 ± 2 mmHg, P = 0.012) and CF-LVAD (80 ± 7 mmHg, P = 0.008) groups. The reactive hyperemic index (RHI), a measure of endothelial function, was significantly higher in the control group (2.373 ± 0.274) than in both the HF (1.543 ± 0.173, P = 0.013) and CF-LVAD (1.355 ± 0.163, P = 0.004) groups; however, there was no significant (P = 0.223) difference in RHI between the HF and CF-LVAD groups. The results of the present study demonstrate that while 1-4 months of CF-LVAD support do not negatively affect microvascular endothelial function, 1-4 months of CF-LVAD support do not significantly improve vascular function in resistance vessels.
authors.affiliation: College of Biological Sciences, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Lou
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Templeton
authors.forename: Ranjit
authors.initials: R
authors.lastname: John
authors.forename: Donald R
authors.initials: DR
authors.lastname: Dengel
mesh_terms: D001794:Blood Pressure; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000503:physiopathology*; D008875:Middle Aged; D008910:Minnesota; D010991:Plethysmography; D011446:Prospective Studies; D011474:Prosthesis Design; D016896:Treatment Outcome; D014655:Vascular Resistance; D016277:Ventricular Function, Left