Systemic Inflammatory Response Syndrome After Contentious-Flow Left Ventricular Assist Device Implantation and Change in Platelet Mitochondrial Membrane Potential

Background: The objective of this study was to investigate the change of platelet function and platelet mitochondrial membrane potential in contentious-flow left ventricular assist device (CF-LVAD) implanted heart failure (HF) patients with or without systemic inflammatory response syndrome (SIRS). Methods and Results: We recruited 31 CF-LVAD patients (16 SIRS and 15 non-SIRS) and 11 healthy volunteers. as control. Pre- and post-implantation blood samples were collected. We used PFA-100 to test platelet functionality. Mitochondrial potential sensitive dye was used to detect platelet dysfunction (mitochondria' membrane potential; Delta Psi(m)) via flow cytometry. The percentage of depolarized-Delta Psi(m) platelets was found to be a preexisting condition in all HF patients before CF-LVAD implantation compared with control subjects (10.3 +/- 6.3% vs 2.8 2.2%; P < .001). As evident from the PFA-100 test, the HF patients who developed SIRS after CF-LVAD implantation had significantly more qualitative platelet defects and thrombocytopathies compared with baseline. After implantation, the depolarized platelets in the SIRS patients increased by 2-fold compared with baseline (18.2 +/- 8.4% vs 9.0 +/- 6.6%; P < .01); whereas no change was noticed in the non-SIRS patients (10.9 +/- 6.2% vs 11.7 +/- 5.8%; P = .75). Conclusions: We identified that platelet function and mitochondria' damage were enhanced in CF-LVAD patients with SIRS. Our findings suggest that depolarization of mitochondrial membrane potential is associated with SIRS after CF-LVAD implantation surgery.