دورية أكاديمية
Impact of Diabetes and Glycemia on Cardiac Improvement and Adverse Events Following Mechanical Circulatory Support.
العنوان: | Impact of Diabetes and Glycemia on Cardiac Improvement and Adverse Events Following Mechanical Circulatory Support. |
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المؤلفون: | Kyriakopoulos CP; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA.; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Taleb I; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA.; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Tseliou E; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA.; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Sideris K; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Hamouche R; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Maneta E; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA.; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Nelson M; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Krauspe E; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Selko S; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Visker JR; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Dranow E; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Goodwin ML; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Alharethi R; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Wever-Pinzon O; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA.; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Fang JC; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Stehlik J; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Selzman CH; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA.; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA., Hanff TC; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA., Drakos SG; Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center) Salt Lake City UT USA.; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Salt Lake City UT USA. |
المصدر: | Journal of the American Heart Association [J Am Heart Assoc] 2024 Jul 16; Vol. 13 (14), pp. e032936. Date of Electronic Publication: 2024 Jul 11. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Oxford : Wiley-Blackwell |
مواضيع طبية MeSH: | Heart-Assist Devices*/adverse effects , Diabetes Mellitus, Type 2*/blood , Diabetes Mellitus, Type 2*/complications , Glycated Hemoglobin*/metabolism , Heart Failure*/mortality , Heart Failure*/blood , Heart Failure*/therapy , Heart Failure*/physiopathology , Ventricular Function, Left* , Blood Glucose*/metabolism, Humans ; Male ; Female ; Middle Aged ; Aged ; Prospective Studies ; Stroke Volume ; Treatment Outcome ; Recovery of Function ; Risk Factors ; Time Factors |
مستخلص: | Background: Type 2 diabetes is prevalent in cardiovascular disease and contributes to excess morbidity and mortality. We sought to investigate the effect of glycemia on functional cardiac improvement, morbidity, and mortality in durable left ventricular assist device (LVAD) recipients. Methods and Results: Consecutive patients with an LVAD were prospectively evaluated (n=531). After excluding patients missing pre-LVAD glycated hemoglobin (HbA1c) measurements or having inadequate post-LVAD follow-up, 375 patients were studied. To assess functional cardiac improvement, we used absolute left ventricular ejection fraction change (ΔLVEF: LVEF post-LVAD-LVEF pre-LVAD). We quantified the association of pre-LVAD HbA1c with ΔLVEF as the primary outcome, and all-cause mortality and LVAD-related adverse event rates (ischemic stroke/transient ischemic attack, intracerebral hemorrhage, gastrointestinal bleeding, LVAD-related infection, device thrombosis) as secondary outcomes. Last, we assessed HbA1c differences pre- and post-LVAD. Patients with type 2 diabetes were older, more likely men suffering ischemic cardiomyopathy, and had longer heart failure duration. Pre-LVAD HbA1c was inversely associated with ΔLVEF in patients with nonischemic cardiomyopathy but not in those with ischemic cardiomyopathy, after adjusting for age, sex, heart failure duration, and left ventricular end-diastolic diameter. Pre-LVAD HbA1c was not associated with all-cause mortality, but higher pre-LVAD HbA1c was shown to increase the risk of intracerebral hemorrhage, LVAD-related infection, and device thrombosis by 3 years on LVAD support ( P <0.05 for all). HbA1c decreased from 6.68±1.52% pre-LVAD to 6.11±1.33% post-LVAD ( P <0.001). Conclusions: Type 2 diabetes and pre-LVAD glycemia modify the potential for functional cardiac improvement and the risk for adverse events on LVAD support. The degree and duration of pre-LVAD glycemic control optimization to favorably affect these outcomes warrants further investigation. |
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معلومات مُعتمدة: | R01 HL135121 United States HL NHLBI NIH HHS; K23 HL150322 United States HL NHLBI NIH HHS; R01 HL132067 United States HL NHLBI NIH HHS; T32 HL007576 United States HL NHLBI NIH HHS; I01 CX002291 United States CX CSRD VA |
فهرسة مساهمة: | Keywords: diabetes; heart assist device; heart failure; left ventricular assist device; myocardial recovery; reverse remodeling |
المشرفين على المادة: | 0 (Glycated Hemoglobin) 0 (Blood Glucose) 0 (hemoglobin A1c protein, human) |
تواريخ الأحداث: | Date Created: 20240711 Date Completed: 20240716 Latest Revision: 20240803 |
رمز التحديث: | 20240803 |
مُعرف محوري في PubMed: | PMC11292740 |
DOI: | 10.1161/JAHA.123.032936 |
PMID: | 38989825 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2047-9980 |
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DOI: | 10.1161/JAHA.123.032936 |