The Impact of Obesity on Left Ventricular Assist Device Outcomes

被引：10

作者：

Zhigalov, Konstantin ^{[1
,2
]}

Sa, Michel Pompeu Barros Oliveira ^{[2
,3
]}

Arjomandi Rad, Arian ^{[2
,4
]}

Vardanyan, Robert ^{[2
,4
]}

Goerdt, Lukas ^{[1
]}

Chrosch, Thomas ^{[1
]}

Zubarevich, Alina ^{[1
]}

Wendt, Daniel ^{[1
]}

Pizanis, Nikolaus ^{[1
]}

Koch, Achim ^{[1
]}

Kamler, Markus ^{[5
]}

Berger, Rafal ^{[6
]}

Schmack, Bastian ^{[1
,2
]}

Ruhparwar, Arjang ^{[1
,2
]}

Popov, Aron-Frederik ^{[2
,6
]}

Weymann, Alexander ^{[1
,2
]}

机构：

[1] Univ Duisburg Essen, Univ Hosp Essen, Dept Thorac & Cardiovasc Surg, West German Heart & Vasc Ctr Essen, D-45122 Essen, Germany

[2] Int Thorac & Cardiovasc Res Assoc ITCVR, D-26133 Oldenburg, Germany

[3] Univ Pernambuco, Dept Cardiovasc Surg Pronto Socorro Cardiol Perna, BR-74970240 Recife, PE, Brazil

[4] Imperial Coll London, Fac Med, Dept Med, London SW7 2AZ, England

[5] Univ Hosp Essen, Dept Cardiothorac Surg, Heart Ctr Essen Huttrop, D-45138 Essen, Germany

[6] Univ Med Ctr Tubingen, Dept Thorac & Cardiovasc Surg, D-72076 Tubingen, Germany

来源：

MEDICINA-LITHUANIA | 2020年 / 56卷 / 11期

关键词：

left ventricular assist device; obesity; mechanical circulatory support; heart failure; cardiac assist and artificial heart; BODY-MASS INDEX; HEART-FAILURE; RISK-FACTOR; WEIGHT-LOSS; TRANSPLANTATION; IMPLANTATION; SUPPORT; RATES;

D O I：

10.3390/medicina56110556

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and Objectives: The understanding of high body mass index (BMI) and outcomes after Left Ventricular Assist Device (LVAD) implantation continues to evolve and the relationship has not been established yet. In this study, we investigated the effects of obesity (BMI > 30 kg/m(2)) on post-LVAD implantation outcomes. HeartWare LVAD and Heart Mate III LVAD were implanted. The primary outcome that was measured was mortality (in-hospital and on follow-up). The secondary outcomes that were measured were major adverse events. Materials and Methods: At our institution, the West German Heart and Vascular Center (Essen, Germany), from August 2010 to January 2020, a total of 210 patients received a long-term LVAD. Patients were stratified according to BMI >= 30 kg/m(2) representing the obesity threshold. The first group (n = 162) had an average BMI of 24.2 kg/m(2) (+/- 2.9), and the second group (n = 48) had an average BMI of 33.9 kg/m(2) (+/- 3.2). Baseline demographics were analysed alongside comorbidities per group. Results: Overall mortality was not significantly different between the obese group (51.1% n = 24) and the nonobese group (55.2%, n = 85) (p = 0.619). The difference between the mean duration of survival of patients who expired after hospital discharge was insignificant (2.1 years +/- 1.6, group 1; 2.6 years +/- 1.5, group 2; p = 0.29). In-hospital mortality was unvaried between the two groups: group 1: n = 34 (44% out of overall group 1 deaths); group 2: n = 11 (45.8% out of overall group 2 deaths) (p > 0.05). Postoperative complications were unvaried between the obese and the non-obese group (all with p > 0.05). However, a significant difference was found with regards to follow-up neurological complications (18.5% vs. 37.8%, p = 0.01) and LVAD thrombosis (14.7% vs. 33.3%, p = 0.01), as both were higher in the obese population. Conclusion: Obesity does not form a barrier for LVAD implantation in terms of mortality (in-hospital and on follow up). However, a significantly higher incidence of follow-up LVAD thrombosis and neurological complications has been found in the obese group of patients.

引用

页码：1 / 10

页数：10

共 32 条

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