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Journal Articles ESC Heart Failure Year : 2021

Characteristics and outcome of ambulatory heart failure patients receiving a left ventricular assist device

Aude Boignard
  • Function : Author
Marie Bielefeld
  • Function : Author
Olivier Bouchot
Nicolas Lellouche
  • Function : Author
  • PersonId : 764872
  • IdRef : 075154625
Thibaud Genet
Romain Eschalier
Nicolas d'Ostrevy
  • Function : Author
  • PersonId : 1345629
  • IdHAL : ndostrevy

Abstract

Aims: Despite regularly updated guidelines, there is still a delay in referral of advanced heart failure patients to mechanical circulatory support and transplant centres. We aimed to analyse characteristics and outcome of non-inotrope-dependent patients implanted with a left ventricular assist device (LVAD).Methods and results: The ASSIST-ICD registry collected LVAD data in 19 centres in France between February 2006 and December 2016. We used data of patients in Interagency Registry for Mechanically Assisted Circulatory Support Classes 4-7. The primary endpoint was survival analysis. Predictors of mortality were searched with multivariable analyses. A total of 303 patients (mean age 61.0 ± 9.9 years, male sex 86.8%) were included in the present analysis. Ischaemic cardiomyopathy was the leading heart failure aetiology (64%), and bridge to transplantation was the main implantation strategy (56.1%). The overall likelihood of being alive while on LVAD support or having a transplant at 1, 2, 3, and 5 years was 66%, 61.7%, 58.7%, and 55.1%, respectively. Age [hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.00-1.05; P = 0.02], a concomitant procedure (HR 2.32, 95% CI 1.52-3.53; P < 0.0001), and temporary mechanical right ventricular support during LVAD implantation (HR 2.94, 95% CI 1.49-5.77; P = 0.002) were the only independent variables associated with mortality. Heart failure medications before or after LVAD implantation were not associated with survival.Conclusion: Ambulatory heart failure patients displayed unsatisfactory survival rates after LVAD implantation. A better selection of patients who can benefit from LVAD may help improving outcomes.
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hal-03338927 , version 1 (09-09-2021)

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Guillaume Baudry, Nicolas Nesseler, Erwan Flecher, André Vincentelli, Céline Goeminne, et al.. Characteristics and outcome of ambulatory heart failure patients receiving a left ventricular assist device. ESC Heart Failure, 2021, 8 (6), pp.5159-5167. ⟨10.1002/ehf2.13592⟩. ⟨hal-03338927⟩
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