LVAD implantation in patients with advanced heart failure modified metabolic profiles, with 63 of 188 measured metabolites altered in HF and three returning to pre-LVAD concentrations at 100 days.
Observational (n=60)
Does LVAD implantation reverse metabolic abnormalities in patients with advanced heart failure (ICM and DCM)?
LVAD implantation partially reverses metabolic abnormalities in advanced heart failure, with specific metabolic changes depending on the underlying etiology (ICM vs. DCM).
Chronic heart failure (HF) is a clinical syndrome characterized by functional impairments of the myocardium. Metabolic and clinical changes develop with disease progression. In an advanced state, left ventricular assist devices (LVADs) are implanted for mechanical unloading. Our study aimed to assess the effects of LVAD implantation on the metabolic phenotypes and their potential to reverse the latter in patients with advanced HF. Plasma metabolites were analyzed by LC-MS/MS in 20 patients with ischemic cardiomyopathy (ICM), 20 patients with dilative cardiomyopathy (DCM), and 20 healthy controls. Samples were collected in HF patients before, 30 days after, and >100 days after LVAD implantation. Out of 188 measured metabolites, 63 were altered in HF. Only three metabolites returned to pre-LVAD concentrations 100 days after LVAD implantation. Pre-LVAD differences between DCM and ICM were mainly observed for amino acids and biogenic amines. This study shows a reversal of metabolite abnormalities in HF as a result of LVAD implantation. The etiology of the underlying disease plays an essential role in defining which specific metabolic parameter is altered in HF and reversed by LVAD implantation. Our findings provide a detailed insight into the disease pattern of ICM and DCM and the potential for reversibility of metabolic abnormalities in HF.
Hilse et al. (2021) conducted an observational in Chronic Heart Failure (n=60). LVAD implantation vs. Pre-LVAD baseline and healthy controls was evaluated on Plasma metabolite concentrations. LVAD implantation in patients with advanced heart failure modified metabolic profiles, with 63 of 188 measured metabolites altered in HF and three returning to pre-LVAD concentrations at 100 days.