Effect of Neurohormonal Blockade Drug Therapy on Outcomes and Left Ventricular Function and Structure After Left Ventricular Assist Device Implantation

Neurohormonal blockade drug therapy (NHBDT) is the cornerstone therapy in heart failure (HF) management for promoting reverse cardiac remodeling and improving outcomes. It's utility in left ventricular assist device (LVAD) supported patients remains undefined. Sixty-four patients who received c...

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Bibliographic Details
Published in:The American journal of cardiology 2016-06, Vol.117 (11), p.1765-1770
Main Authors: Grupper, Avishay, MD, Zhao, Yanjun M., PharmD, Sajgalik, Pavol, MD, Joyce, Lyle D., MD, Park, Soon J., MD, Pereira, Naveen L., MD, Stulak, John M., MD, Burnett, John C., MD, Edwards, Brooks S., MD, Daly, Richard C., MD, Kushwaha, Sudhir S., MD, Schirger, John A., MD
Format: Article
Language:English
Subjects:
Beta blockers
Blood pressure
Cardiology
Cardiomyopathy
Cardiovascular
Cardiovascular disease
Clinical outcomes
Diuretics
Drug dosages
Drug therapy
Echocardiography
Enzymes
Female
Follow-Up Studies
Heart failure
Heart Failure - diagnosis
Heart Failure - epidemiology
Heart Failure - physiopathology
Heart Failure - therapy
Heart rate
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Heart-Assist Devices
Hospitalization
Hospitals
Humans
Male
Middle Aged
Minnesota - epidemiology
Morbidity - trends
Mortality
Neurotransmitter Agents - therapeutic use
Patients
Prognosis
Retrospective Studies
Rodents
Studies
Survival Rate - trends
Transplants & implants
Ventricular Function, Left - physiology
Ventricular Remodeling - physiology
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Summary:Neurohormonal blockade drug therapy (NHBDT) is the cornerstone therapy in heart failure (HF) management for promoting reverse cardiac remodeling and improving outcomes. It's utility in left ventricular assist device (LVAD) supported patients remains undefined. Sixty-four patients who received continuous flow LVAD at our institution were retrospectively reviewed and divided into 2 groups: no-NHBDT group (n = 33) received LVAD support only and NHBDT group (n = 31) received concurrent NHBDT based on the clinical judgment of the attending physicians. Cardiac remodeling (echocardiographic parameters and biomarkers) and clinical outcome (functional status, HF-related hospital readmissions, and mortality) data were collected. A statistically significant increase in ejection fraction, decrease in LV end-diastolic diameter index and LV mass index, and a sustained reduction in N-terminal pro B-type natriuretic peptide (NTproBNP) were observed in the NHBDT group at 6 months after LVAD implant (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2016.03.011