Improved 6 Minute Walk Distance and Brain-Type Natriuretic Peptide After Continuous-Flow Ventricular Assist Device Placement in Children. Issue 7 (September 2019)

• Record Type: Journal Article
• Authors: Goldberg, Jason F.; Schlosser, Robin S.; Walrath, James G.; Morris, Shaine A.; Elias, Barbara A.; Price, Jack F.; Cabrera, Antonio G.; Denfield, Susan W.; Dreyer, Wiliam J.; Wang, Yunfei; Adachi, Iki; Jeewa, Aamir
• Is Part Of: ASAIO journal. Volume 65:Issue 7(2019)
• Publication Date: 2019-09
• Subjects: mechanical circulatory support -- heart-assist devices -- pediatrics -- heart failure -- rehabilitation; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000000865
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : Despite increasing continuous-flow ventricular assist device (CF-VAD) use in children, minimal data exist regarding the functional recovery and rehabilitation potential after device placement. We hypothesized that after CF-VAD implantation, children would demonstrate a time-limited improvement in 6 minute walk distance (6MWD) and brain-type natriuretic peptide (BNP). A retrospective cohort study of 27 patients was conducted, those <18 years of age at a tertiary-care center during the study period. Seventy-four percent were male; median age was 12.7 years. Six minute walk distance and BNP were evaluated within 365 days of implantation. Associations were examined before and after 90 days postimplantation because a plateau in both values was seen after 90 days. Data included 92 6MWD and 341 BNP values. In the first 90 days, 6MWD increased by 12 percent predicted (%P) per 30 days ( P < 0.01); with no significant change thereafter, increasing 0.6 %P per 30 days ( P = 0.482). In the first 90 days, BNP decreased by 59% per 30 days ( P < 0.01); with no significant change thereafter, increasing 1.2% per 30 days ( P = 0.561). Six minute walk distance and BNP improved after CF-VAD implantation, with a significant improvement only in the first 90 days. Routine use of 6MWD and BNP can help in assessment of functional recovery in children after CF-VAD placement.