Abnormally High Levels of Inflammatory Markers in Recipients of Continuous Flow Left Ventricular Assist Devices

Abstract

Purpose Early activation of inflammatory markers immediately after implantation of left ventricular assist devices (LVADs) predicts multiple organ failure. Although the newer generation continuous flow (CF)-LVADs provide clinical advantages over the pulsatile pumps, the effects of low pulsatility on inflammation are not completely understood in this patient population. Under continuous-flow conditions, the levels of neurohormones, which are known to augment inflammation in heart failure (HF), are elevated. We hypothesize that in CF-LVAD recipients the levels of inflammatory markers are higher than both healthy controls and HF patients. The aim of our study was to compare the levels of inflammation in CF-LVAD recipients to those of healthy controls (HCs) and HF patients who were candidates for CF-LVADs. Methods and Materials The levels of the inflammatory markers were measured in 18 CF-LVAD recipients and compared to those of 14 HCs and 14 HF patients who were candidates for CF-LVADs. Results The levels of GM-CSF, MIP-1 beta and MDC were significantly higher in the CF-LVAD group compared to both the HC and the HF groups, whereas no significant differences were observed between the HC and the HF groups. Compared to the HC group, CRP, IP-10, MCP-1 and IL-8 levels were significantly higher in both the CF-LVAD and HF groups, while no significant differences were observed between the CF-LVAD recipients and the HF patients. [ figure 1 ] Conclusions We found that inflammation was high in CF-LVAD recipients. Further studies should investigate the time course of elevation of inflammatory mediators from pre- to post- CF-LVAD implantation and following long term CF-LVAD support.