Abstract
Background: Thus far, continuous flow (CF) left ventricular assist device (LVAD) has replaced pulsatile flow (PF) LVAD because of its advantage in better patients sur- vival and higher quality of life. However, effect on left ventricular (LV) reverse re- modeling between both types of LVAD has not been analyzed well. Methods and Results: We retrospectively analyzed 52 patients with stage D heart failure due to dilated cardiomyopathy who had received LVAD implantation (PF type, 22; CF type, 30) and been followed for 6 months after the surgery. We defined LV reverse remodeling as the following criteria; C1: %change in LV ejection fraction (EF) O0% (17 patients (32.7%) accomplished) or C2: achieved LVEF O35% (15 patients (28.8%) accomplished) at 6 months after LVAD implantation. Univariable logistic re- gression analyses for LV reverse remodeling demonstrated that PF LVAD usage was an only independent predictive factor for each C1 and C2 among preoperative vari- ables including demographic, echocardiographic, and hemodynamic parameters. Pa- tients who accomplished C1 or C2 had less aortic valve insufficiency and lower plasma BNP at 6 months after the surgery. Three patients (5.8%), in whom LVADs were explanted, all implemented both C1 and C2. Conclusions: PF LVAD may have an advantage in LV reverse remodeling compared with CF LVAD.
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