Systemic Inflammatory Response Syndrome After Contentious-Flow Left Ventricular Assist Device Implantation and Change in Platelet Mitochondrial Membrane Potential.
BACKGROUND
The objective of this study was to investigate the change of platelet function and platelet mitochondrial membrane potential in contentious-flow left ventricular assist device (CF-LVAD)-implanted heart failure (HF) patients with or without systemic inflammatory response syndrome (SIRS).


RESULTS
We recruited 31 CF-LVAD patients (16 SIRS and 15 non-SIRS) and 11 healthy volunteers as control. Pre- and post-implantation blood samples were collected. We used PFA-100 to test platelet functionality. Mitochondrial potential-sensitive dye was used to detect platelet dysfunction (mitochondrial membrane potential; ΔΨm) via flow cytometry. The percentage of depolarized-ΔΨm platelets was found to be a preexisting condition in all HF patients before CF-LVAD implantation compared with control subjects (10.3 ± 6.3% vs 2.8 ± 2.2%; P < .001). As evident from the PFA-100 test, the HF patients who developed SIRS after CF-LVAD implantation had significantly more qualitative platelet defects and thrombocytopathies compared with baseline. After implantation, the depolarized platelets in the SIRS patients increased by 2-fold compared with baseline (18.2 ± 8.4% vs 9.0 ± 6.6%; P < .01); whereas no change was noticed in the non-SIRS patients (10.9 ± 6.2% vs 11.7 ± 5.8%; P = .75).


CONCLUSIONS
We identified that platelet function and mitochondrial damage were enhanced in CF-LVAD patients with SIRS. Our findings suggest that depolarization of mitochondrial membrane potential is associated with SIRS after CF-LVAD implantation surgery.
Department of Surgery, Artificial Organs Laboratory, University of Maryland School of Medicine, Baltimore, Maryland.
Nandan K
NK
Mondal
Department of Clinical Engineering, University of Maryland Medical Center, Baltimore, Maryland.
Erik N
EN
Sorensen
Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
Erika D
ED
Feller
Department of Surgery, Artificial Organs Laboratory, University of Maryland School of Medicine, Baltimore, Maryland.
Si M
SM
Pham
Department of Surgery, Artificial Organs Laboratory, University of Maryland School of Medicine, Baltimore, Maryland.
Bartley P
BP
Griffith
Department of Surgery, Artificial Organs Laboratory, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: zhongjun.wu@louisville.edu.
Zhongjun J
ZJ
Wu
D000328:Adult; D000368:Aged; D001791:Blood Platelet Disorders / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D001792:Blood Platelets / Q000378:metabolism*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000503:physiopathology; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D053078:Membrane Potential, Mitochondrial; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019990:Perioperative Care / Q000379:methods; D010979:Platelet Function Tests / Q000379:methods; D012720:Severity of Illness Index; D013223:Statistics as Topic; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology
Heart failure; left ventricular assist device; platelet mitochondrial dysfunction; systemic inflammatory response syndrome