title: Endothelial dysfunction expressed as endothelial microparticles in patients with end-stage heart failure.
abstract: Left ventricular assist devices (LVAD), currently used in treatment of terminal heart failure, are working on principle of rotary pump, which generates continuous blood flow. Non-pulsatile flow is supposed to expose endothelial cells to high stress and potential damage. Therefore, we investigated longitudinal changes in concentration of circulating endothelial microparticles (EMP) as a possible marker of endothelial damage before and after implantation of LVAD. Study population comprised 30 patients with end-stage heart failure indicated for implantation of the Heart Mate II LVAD. Concentrations of microparticles were measured as nanomoles per liter relative to phosphatidylserine before and 3 months after implantation. At 3 months after implantation we observed significant decrease in concentration of EMP [5.89 (95 % CI 4.31-8.03) vs. 3.69 (95 % CI 2.70-5.03), p=0.03] in the whole group; there was no difference observed between patients with ischemic etiology of heart failure (n=18) and with heart failure of non-ischemic etiology (n=12). In addition, heart failure etiology had no effect on the rate of EMP concentration decrease with time. These results indicate possibility that LVAD do not cause vascular damage 3 months after implantation. Whether these results suggest improvement of vascular wall function and of endothelium is to be proved in long-term studies.
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic. japi@ikem.cz.
authors.forename: P
authors.initials: P
authors.lastname: Ivak
authors.forename: J
authors.initials: J
authors.lastname: Pitha
authors.forename: P
authors.initials: P
authors.lastname: Wohlfahrt
authors.forename: I
authors.initials: I
authors.lastname: Kralova Lesna
authors.forename: P
authors.initials: P
authors.lastname: Stavek
authors.forename: Z
authors.initials: Z
authors.lastname: Dorazilova
authors.forename: J
authors.initials: J
authors.lastname: Stepankova
authors.forename: J
authors.initials: J
authors.lastname: Maly
authors.forename: M
authors.initials: M
authors.lastname: Pokorny
authors.forename: I
authors.initials: I
authors.lastname: Netuka
mesh_terms: D000368:Aged; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D006353:Heart-Assist Devices / Q000639:trends; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged