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Coronary arterial function is not impaired in patients following continuous‐flow left ventricular assist device implantation
Author(s) -
Johnson Elizabeth,
Diakos Nikos,
Selzman Craig,
Reid Bruce,
Stehlik Josef,
Kfoury Abdallah,
Saidi Abdulfatah,
WeverPinzon Omar,
Verma Divya R,
Yen ChiGang,
Li Dean,
Drakos Stavros,
Symons J David
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.1185.11
Subject(s) - medicine , cardiology , coronary arteries , pulsatile flow , ventricle , sodium nitroprusside , ventricular assist device , contraction (grammar) , transplantation , vasodilation , heart failure , heart transplantation , artery , nitric oxide
Continuous‐flow left ventricular assist devices (LVADs) are used in advanced heart failure patients either to bridge them to transplantation or as a permanent‐destination therapy. We sought to determine whether chronic exposure to non‐pulsatile blood flow and acute increases in coronary perfusion pressure associated with LVAD implantation attenuate arterial function. A transmural biopsy of the left‐ventricle was obtained from seven male patients (52±6 years old) at the time of LVAD implant (pre) and 142±12 days later (post) upon LVAD explant. Arteries were dissected free and function was assessed using isometric tension techniques. First, Lmax tension was determined on each vessel. Next, contraction‐response curves to potassium chloride (KCl, 10–100 mM) were performed. To determine endothelium‐dependent and – independent vasorelaxation, respectively, concentration‐response curves to bradykinin (BK, 10 −6 to 10 −10 M) and sodium nitroprusside (SNP, 10 −4 to 10 −9 M) were completed on vessels precontracted to ~65% of maximal tension development. Maximal KCl‐evoked contraction (0.99±0.22 and 0.69±0.14 mg tension development/μm vessel length), maximal BK‐evoked vasorelaxation (64±13% and 80±7%), and maximal SNP‐evoked vasorelaxation (92±3% and 92±4%), was similar in arteries obtained from pre (n=13 arteries, 206±40 μm i.d.) and post (n=14 arteries, 288±24 μm i.d.) transmural biopsy samples, respectively. These preliminary data indicate that coronary vascular function is not attenuated by LVAD implantation.