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Sympathetic vasoconstrictor activity before and after left ventricular assist device implantation in patients with end‐stage heart failure

Heusser, K. and Wittkoepper, J. and Bara, C. and Haverich, A. and Diedrich, A. and Levine, B. and Schmitto, J. and Jordan, J. and Tank, J. (2021) Sympathetic vasoconstrictor activity before and after left ventricular assist device implantation in patients with end‐stage heart failure. European Journal of Heart Failure, 23 (11), pp. 1955-1959. Wiley. doi: 10.1002/ejhf.2344. ISSN 1388-9842.

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Official URL: http://dx.doi.org/10.1002/ejhf.2344

Abstract

Aims: Sympathetic overactivity, which predicts poor outcome in patients with heart failure, normalizes following cardiac transplantation. We tested the hypothesis that haemodynamic improvement following left ventricular assist device (LVAD) implantation is also associated with reductions in centrally generated sympathetic activity. Methods and results: In eight patients with heart failure (two women, six men, age 44-66 years), we continuously recorded electrocardiogram, beat-to-beat finger blood pressure, respiration, and muscle sympathetic nerve activity (MSNA) before and after implantation of the continuous-flow LVAD devices HeartWare HVAD (n = 4) and HeartMate II (n = 2), and the non-continuous-flow device HeartMate 3 (n = 2). LVAD implantation increased cardiac output by 1.29 ± 0.88 L/min (P = 0.060) and mean arterial pressure by 16.2 ± 7.9 mmHg (P < 0.001), while reducing pulse pressure by 25.3 ± 9.8 mmHg (P < 0.001). LVAD implantation did not change MSNA burst frequency (-1.3 ± 7.5 bursts/min, P = 0.636), total activity (+0.62 ± 1.83 au, P = 0.369), or normalized activity (+0.63 ± 4.23, P = 0.685). MSNA burst incidence was decreased (-7.8 ± 9.3 bursts/100 heart beats, P = 0.049). However, cardiac ectopy altered MSNA bursting patterns that could be mistaken for sympatholysis. Conclusion: Implantation of current design LVAD does not consistently normalize sympathetic activity in patients with end-stage heart failure despite haemodynamic improvement.

Item URL in elib:https://elib.dlr.de/144554/
Document Type:Article
Title:Sympathetic vasoconstrictor activity before and after left ventricular assist device implantation in patients with end‐stage heart failure
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iD
Heusser, K.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Wittkoepper, J.Institute of Clinical Pharmacology, Hannover Medical School, Hannover, GermanyUNSPECIFIED
Bara, C.Department of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, GermanyUNSPECIFIED
Haverich, A.Department of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, GermanyUNSPECIFIED
Diedrich, A.Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TNUNSPECIFIED
Levine, B.Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, DallasUNSPECIFIED
Schmitto, J.Department of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, GermanyUNSPECIFIED
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany and Lehrstuhl für Luft- und Raumfahrtmedizin, Universität zu Köln; Jens.Jordan (at) dlr.dehttps://orcid.org/0000-0003-4518-0706
Tank, J.Cardiovascular Aerospace Medicine Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Jens.Tank (at) dlr.dehttps://orcid.org/0000-0002-5672-1187
Date:8 September 2021
Journal or Publication Title:European Journal of Heart Failure
Refereed publication:Yes
Open Access:Yes
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:23
DOI :10.1002/ejhf.2344
Page Range:pp. 1955-1959
Publisher:Wiley
ISSN:1388-9842
Status:Published
Keywords:Baroreflex; Heart failure; Left ventricular assist device; Microneurography; Sympathetic nerve activity
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - CardioBrain
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Institute of Aerospace Medicine > Leitungsbereich ME
Deposited By: Schrage, Larissa
Deposited On:21 Oct 2021 11:40
Last Modified:08 Feb 2022 11:05

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