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Neurohormone levels remain elevated in continuous flow left ventricular assist device recipients
Author(s) -
GrosmanRimon Liza,
McDonald Michael A.,
Freedman Danit,
Yip Paul,
Cherney David Z.,
Rao Vivek
Publication year - 2018
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.13731
Subject(s) - neurohormones , medicine , aldosterone , cardiology , plasma renin activity , heart failure , norepinephrine , hemodynamics , ventricular assist device , renin–angiotensin system , endocrinology , blood pressure , hormone , dopamine
The levels of neurohormones were assessed in continuous‐flow left ventricular assist device (CF‐LVAD) recipients and compared to patients with heart failure (HF) and to healthy controls (HCs), and CF‐LVAD recipients with closed or open aortic valves (AVs). Methods Aldosterone, norepinephrine, and renin levels were assessed in a total of 46 participants, including CF‐LVAD recipients ( n = 18), HF patients ( n = 14), and HC individuals ( n = 14). Echocardiographic assessments were performed to evaluate cardiac functions and aortic valve status and neurohormone levels were compared between CF‐LVAD recipients with closed or open AVs. Results Aldosterone, norepinephrine, and renin levels were elevated to a similar extent in CF‐LVAD recipients and HF patients, compared to HC individuals. In the CF‐LVAD group, no differences were found between the levels of norepinephrine and aldosterone between recipients with AV opened or closed. With an open AVs, CF‐LVAD recipients had higher levels of renin compared to recipients with closed AVs. However, an open AV was only a weak predictor of higher levels of renin. Conclusion The findings that aldosterone, norepinephrine, and renin were elevated after restoration of hemodynamic functions during LVAD support suggest that the levels of neurohormones did not normalize. Future studies should investigate whether AV status in CF‐LVAD recipients affects the levels of RAAS neurohormones and the mechanisms and clinical implications of elevated levels of neurohormones in CF‐LVAD patients.