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. 2022 Dec 20;12(1):29.
doi: 10.3390/jcm12010029.

The Effect of Age on Non-Invasive Hemodynamics in Chronic Heart Failure Patients on Left-Ventricular Assist Device Support: A Pilot Study

Else-Marie van de Vreede  1 , Floor van den Berg  1 , Parsa Jahangiri  2 , Kadir Caliskan  2 , Francesco Mattace-Raso  1
Affiliations

The Effect of Age on Non-Invasive Hemodynamics in Chronic Heart Failure Patients on Left-Ventricular Assist Device Support: A Pilot Study

Else-Marie van de Vreede et al. J Clin Med. .

Abstract

Background: Implantation of continuous flow left ventricular assist devices (LVAD’s) has been increasingly used in patients with advanced heart failure (HF). Little is known about the non-invasive hemodynamics and the relationship with adverse events in this specific group of patients. We aimed to identify any differences in non-invasive hemodynamics in patients with an LVAD in different age categories and to investigate if there is an association with major adverse events. Methods: In this observational cross-sectional study, HF patients with a continuous flow LVAD were included. Non-invasive hemodynamic parameters were measured with a validated, automated oscillometric blood pressure monitor. The occurrences of adverse events were registered by reviewing the medical records of the patients. An independent-samples T-test and Chi-square test were used to compare different groups of patients. Results: Forty-seven patients were included; of these, only 12 (25.6%) had a successful measurement. Heart rate, heart rate-adjusted augmentation index, and pulse wave velocity were higher in the ≥55 years of age LVAD group compared to the <55 years of age LVAD group (all p < 0.05). Stroke volume was significantly lower in the ≥55 years of age LVAD group compared to the <55 years of age LVAD group (p = 0.015). Patients with adverse events such as cardiovascular events, GI-bleeding, or admission to a hospital had lower central pulse pressure (cPP) than patients without any adverse event. Conclusion: Older LVAD patients have a significantly higher heart rate, heart rate-adjusted augmentation index, and pulse wave velocity and a significantly lower stroke volume compared to participants aged < 55 years. The pulsatile component of blood pressure was decreased in patients with adverse events.

Keywords: LVAD; adverse events; aging; blood pressure; continuous flow; heart failure; non-invasive hemodynamics; non-pulsatility.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart inclusion of patients.
Figure 2
Figure 2
Distribution of non-invasive hemodynamics in HF with an LVAD within different age categories (A–H). Abbreviations: cSBP, central systolic blood pressure; cDBP, central diastolic blood pressure; cPP, central pulse pressure; HR, heart rate; SV, stroke volume; CO, cardiac output; AIx, augmentation index; PWV, pulse wave velocity. Note: bars represent mean values, dots represent individual patients. * p = 0.034; ** p = 0.015; *** p = 0.013; **** p = 0.001.
Figure 3
Figure 3
Distribution of non-invasive hemodynamics in HF with an LVAD with and without adverse events (A–H). Abbreviations: cSBP, central systolic blood pressure; cDBP, central diastolic blood pressure; cPP, central pulse pressure; HR, heart rate; SV, stroke volume; CO, cardiac output; AIx, augmentation index; PWV, pulse wave velocity. Note: bars represent mean values, dots represent individual patients. * p = 0.044.
See this image and copyright information in PMC

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