Serum Brain Natriuretic Peptide Concentration 60 Days After Surgery as a Predictor of Long-Term Prognosis in Patients Implanted With a Left Ventricular Assist Device. Issue 4 (July 2015)

• Record Type: Journal Article
• Authors: Sato, Takuma; Seguchi, Osamu; Iwashima, Yoshio; Yanase, Masanobu; Nakajima, Seiko; Hieda, Michinari; Watanabe, Takuya; Sunami, Haruki; Murata, Yoshihiro; Hata, Hiroki; Fujita, Tomoyuki; Kobayashi, Junjiro; Nakatani, Takeshi
• Is Part Of: ASAIO journal. Volume 61:Issue 4(2015)
• Publication Date: 2015-07
• Subjects: natriuretic peptide -- left ventricular assist device -- heart failure -- cardiac recovery -- long-term prognosis; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000000237
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : Mechanical circulatory support by a left ventricular assist device (LVAD) is used to bridge patients with advanced heart failure to transplant or as a definitive treatment. We retrospectively sought predictors of long-term outcome in a cohort of 83 patients who had undergone LVAD treatment. We subjected perioperative clinical data of patients to statistical analysis to establish parameters associated with all-cause mortality, and the cutoff values, sensitivity, and specificity of those that had a statistically significant relation with survival. Mean follow-up was 717 days (standard deviation, 334 days; range, 17–1, 592 days). Fourteen patients (16.8%) died, but nine (10.8%) were weaned from support. Serum brain natriuretic peptide (BNP) concentration measured 60 days after implantation was significantly associated with all-cause mortality. The optimal BNP cutoff value to predict death during LVAD support was 322 pg/ml, with a sensitivity of 71.4% and specificity of 79.8%. Two-year survival was 92.0% in those with 60 days serum BNP concentration <322 pg/ml compared with 70.5% in those in whom it was ≥322 pg/ml ( p = 0.003). The relation between BNP and survival likely reflects recovery of native myocardial function and improvements in global health and should assist clinicians in the on-going management of long-term LVAD therapy.