Sympathetic Markers are Different Between Clinical Responders and Nonresponders After Left Ventricular Assist Device Implantation.
Quin E Denfeld, Christopher S Lee, William R Woodward and 3 others
PMID 31094762WHAT IT FOUND
Patients who felt better after LVAD implantation had lower pre-surgery βARK1 and higher DHPG levels than those who did not improve.
These sympathetic markers differed at baseline and did not change significantly after surgery, suggesting pre-implant profiles may track with quality of life outcomes.
Key findings
01Clinical responders had significantly lower pre-implant plasma βARK1 levels compared with non-responders.
02Clinical responders had significantly higher pre-implant plasma DHPG levels compared with non-responders.
03Changes in plasma βARK1, NE, and DHPG over time were not significantly different between clinical responders and non-responders.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size was very small (39 patients), which reduced the power to detect differences. The study was conducted at a single center with a sample that was mostly male, non-Hispanic Caucasian, and had non-ischemic heart failure, limiting generalizability. The study did not assess other inputs to sympathetic activation or account for time-varying covariates like NT-proBNP. There is no gold standard measure for health-related quality of life in LVAD patients.
Declared interests
The study was supported by the National Institutes of Health. No other conflicts of interest are explicitly detailed in the provided text.
The easy way to misread this
Do not interpret the baseline differences in βARK1 and DHPG as evidence that these markers change in response to LVAD implantation. The study found that the rate of change in these markers over 6 months was not significantly different between responders and non-responders.