Plasma Volume and Its Regulatory Factors in Congestive Heart Failure After Implantation of Long-term Left Ventricular Assist Devices

James, Karen B.; McCarthy, Patrick M.; Jaalouk, Safwan; Bravo, Emmanuel L.; Betkowski, Adam; Thomas, James D.; Nakatani, Satoshi; Fouad‐Tarazi, Fetnat M.

doi:10.1161/01.cir.93.8.1515

Cited by 50 publications

(28 citation statements)

References 18 publications

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“…This suggests that the RAAS activation in HF is importantly reduced after LVAD implantation, providing biochemical confirmation of the improvement in hemodynamic status [23]. James et al [15] also found that in BTT patients, plasma renin activity and plasma aldosterone decreased significantly from baseline to week 4, and to week 8 after implantation of LVAD. Furthermore, the reduction of RAAS activity occurred earlier than the reduction of plasma volume and plasma atrial natriuretic peptide level, suggesting the improvement of cardiac function by LVAD was associated with normalization of volume load secondary to normalization of its regulatory substances.…”

Section: Renal Hemodynamics and Physiological Pathological Changementioning

confidence: 90%

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Implantable Left Ventricular Assist Devices and the Kidney

Mao

Katz²,

Kim

et al. 2014

Blood Purif

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The use of left ventricular assist devices (LVADs) in treating patients with advanced heart failure restores cardiac output resulting in improved perfusion to multiple organ systems with important clinical benefits. Renal pathophysiology during LVAD support remains an evolving, poorly understood, and potentially dynamic problem. Changes in renal function after LVAD placement have been investigated in multiple studies with contradictory results. Renal dysfunction is common prior to LVAD placement, which complicates postoperative clinical outcomes. The purpose of this review is to assess the latest information regarding the effects of LVADs on renal function with regard to hemodynamics, physiology, pathology and clinical issues prior to and after placement of the devices. The review should then aid in identifying patients best suited to benefit from this technology and to refine the therapy to reduce associated risks.

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Section: Renal Hemodynamics and Physiological Pathological Changementioning

confidence: 90%

“…It is also possible that improved hemodynamic status and corrected neurohormonal dysregulation [4,15] may improve renal function and contribute to prolonged survival [16]. The relationship between renal function and LVAD is complex.…”

Section: Introductionmentioning

confidence: 99%

Implantable Left Ventricular Assist Devices and the Kidney

Mao

Katz²,

Kim

et al. 2014

Blood Purif

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“…Research on pulsatile device types and kidney function may have limited their generalizability to contemporary-era CF-LVAD patients. Historical physiological studies in patients who received PF-LVAD therapy have demonstrated improved systemic perfusion [20] and decreased levels of renin, aldosterone, and vasopressin [21]. Welp et al [12] demonstrated that the renin levels improved in PF-LVAD and CF-LVAD patient groups, but the improvement was more marked in the PF-LVAD group.…”

Section: What Effect Does Lvad Physiology Have On Kidney Function?mentioning

confidence: 99%

Kidney Dysfunction and Left Ventricular Assist Device Support: A Comprehensive Perioperative Review

et al. 2015

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Left ventricular assist devices (LVADs) are used increasingly as a bridge to transplantation or as destination therapy in end-stage heart failure patients who do not respond to optimal medical therapy. Many of these patients have end-organ dysfunction, including advanced kidney dysfunction, before and after LVAD implantation. Kidney dysfunction is a marker of adverse outcomes, such as increased morbidity and mortality. This review discusses kidney dysfunction and associated management strategies during the dynamic perioperative time period of LVAD implantation. Furthermore, we suggest potential future research directions to better understand the complex relationship between renal pathophysiology and mechanical circulatory support.

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“…Specifically, atrial natriuretic peptide, aldosterone, renin, and arginine vasopressin have all been shown to decrease after LVAD placement (16). Systemic perfusion improves, as evidenced by improvement in renal, hepatic, and neurocognitive function that occurs in most patients a few weeks after LVAD placement (17,18).…”

Section: Morbidity and Mortality After Lvad Implantationmentioning

confidence: 99%

Renal Failure in Patients with Left Ventricular Assist Devices

Patel

Adeseun

Ahmed

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryImplantable left ventricular assist devices (LVADs) are increasingly being used as a bridge to transplantation or as destination therapy in patients with end stage heart failure refractory to conventional medical therapy. A significant number of these patients have associated renal dysfunction before LVAD implantation, which may improve after LVAD placement due to enhanced perfusion. Other patients develop AKI after implantation. LVAD recipients who develop AKI requiring renal replacement therapy in the hospital or who ultimately require longterm outpatient hemodialysis therapy present management challenges with respect to hemodynamics, volume, and dialysis access. This review discusses the mechanics of a continuous-flow LVAD (the HeartMate II), the effects of continuous blood flow on the kidney, renal outcomes of patients after LVAD implantation, dialysis modality selection, vascular access, hemodynamic monitoring during the dialytic procedure, and other issues relevant to caring for these patients.

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Plasma Volume and Its Regulatory Factors in Congestive Heart Failure After Implantation of Long-term Left Ventricular Assist Devices

Cited by 50 publications

References 18 publications

Implantable Left Ventricular Assist Devices and the Kidney

Implantable Left Ventricular Assist Devices and the Kidney

Kidney Dysfunction and Left Ventricular Assist Device Support: A Comprehensive Perioperative Review

Renal Failure in Patients with Left Ventricular Assist Devices

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