Abstract
Background Clinical response to left ventricular assist devices (LVADs), as measured by health-related quality of life, varies among patients after implantation; however, it is unknown which pathophysiological mechanisms underlie differences in clinical response by health-related quality of life. Objective The purpose of this study was to compare changes in sympathetic markers (β-adrenergic receptor kinase-1 [βARK1], norepinephrine [NE], and 3,4-dihydroxyphenylglycol [DHPG]) between health-related quality of life clinical responders and nonresponders from pre-to post-LVAD implantation. Methods We performed a secondary analysis on a subset of data from a cohort study of patients from pre-to 1, 3, and 6 months after LVAD implantation. Clinical response was defined as an increase of 5 points or higher on the Kansas City Cardiomyopathy Questionnaire Clinical Summary score from pre-to 6 months post-LVAD implantation. We measured plasma βARK1 level with an enzyme-linked immunosorbent assay and plasma NE and DHPG levels with high-performance liquid chromatography with electrochemical detection. Latent growth curve modeling was used to compare the trajectories of markers between groups. Results The mean (SD) age of the sample (n = 39) was 52.9 (13.2) years, and most were male (74.4%) and received LVADs as bridge to transplantation (69.2%). Preimplantation plasma βARK1 levels were significantly higher in clinical responders (n = 19) than in nonresponders (n = 20) (P =.001), but change was similar after LVAD (P =.235). Preimplantation plasma DHPG levels were significantly lower in clinical responders than in nonresponders (P =.002), but the change was similar after LVAD (P =.881). There were no significant differences in plasma NE levels. Conclusions Preimplantation βARK1 and DHPG levels are differentiating factors between health-related quality of life clinical responders and nonresponders to LVAD, potentially signaling differing levels of sympathetic stimulation underlying clinical response.
| Original language | English (US) |
|---|---|
| Pages (from-to) | E1-E10 |
| Journal | Journal of Cardiovascular Nursing |
| Volume | 34 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 1 2019 |
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Keywords
- Adrenergic receptor kinase-1
- Health-related quality of life
- Left ventricular assist device
- Norepinephrine
- Sympathetic nervous system
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Advanced and Specialized Nursing
Cite this
Sympathetic Markers are Different between Clinical Responders and Nonresponders after Left Ventricular Assist Device Implantation. / Denfeld, Quin; Lee, Christopher; Woodward, William; Hiatt, Shirin O.; Mudd, James; Habecker, Beth.
In: Journal of Cardiovascular Nursing, Vol. 34, No. 4, 01.07.2019, p. E1-E10.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Sympathetic Markers are Different between Clinical Responders and Nonresponders after Left Ventricular Assist Device Implantation
AU - Denfeld, Quin
AU - Lee, Christopher
AU - Woodward, William
AU - Hiatt, Shirin O.
AU - Mudd, James
AU - Habecker, Beth
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background Clinical response to left ventricular assist devices (LVADs), as measured by health-related quality of life, varies among patients after implantation; however, it is unknown which pathophysiological mechanisms underlie differences in clinical response by health-related quality of life. Objective The purpose of this study was to compare changes in sympathetic markers (β-adrenergic receptor kinase-1 [βARK1], norepinephrine [NE], and 3,4-dihydroxyphenylglycol [DHPG]) between health-related quality of life clinical responders and nonresponders from pre-to post-LVAD implantation. Methods We performed a secondary analysis on a subset of data from a cohort study of patients from pre-to 1, 3, and 6 months after LVAD implantation. Clinical response was defined as an increase of 5 points or higher on the Kansas City Cardiomyopathy Questionnaire Clinical Summary score from pre-to 6 months post-LVAD implantation. We measured plasma βARK1 level with an enzyme-linked immunosorbent assay and plasma NE and DHPG levels with high-performance liquid chromatography with electrochemical detection. Latent growth curve modeling was used to compare the trajectories of markers between groups. Results The mean (SD) age of the sample (n = 39) was 52.9 (13.2) years, and most were male (74.4%) and received LVADs as bridge to transplantation (69.2%). Preimplantation plasma βARK1 levels were significantly higher in clinical responders (n = 19) than in nonresponders (n = 20) (P =.001), but change was similar after LVAD (P =.235). Preimplantation plasma DHPG levels were significantly lower in clinical responders than in nonresponders (P =.002), but the change was similar after LVAD (P =.881). There were no significant differences in plasma NE levels. Conclusions Preimplantation βARK1 and DHPG levels are differentiating factors between health-related quality of life clinical responders and nonresponders to LVAD, potentially signaling differing levels of sympathetic stimulation underlying clinical response.
AB - Background Clinical response to left ventricular assist devices (LVADs), as measured by health-related quality of life, varies among patients after implantation; however, it is unknown which pathophysiological mechanisms underlie differences in clinical response by health-related quality of life. Objective The purpose of this study was to compare changes in sympathetic markers (β-adrenergic receptor kinase-1 [βARK1], norepinephrine [NE], and 3,4-dihydroxyphenylglycol [DHPG]) between health-related quality of life clinical responders and nonresponders from pre-to post-LVAD implantation. Methods We performed a secondary analysis on a subset of data from a cohort study of patients from pre-to 1, 3, and 6 months after LVAD implantation. Clinical response was defined as an increase of 5 points or higher on the Kansas City Cardiomyopathy Questionnaire Clinical Summary score from pre-to 6 months post-LVAD implantation. We measured plasma βARK1 level with an enzyme-linked immunosorbent assay and plasma NE and DHPG levels with high-performance liquid chromatography with electrochemical detection. Latent growth curve modeling was used to compare the trajectories of markers between groups. Results The mean (SD) age of the sample (n = 39) was 52.9 (13.2) years, and most were male (74.4%) and received LVADs as bridge to transplantation (69.2%). Preimplantation plasma βARK1 levels were significantly higher in clinical responders (n = 19) than in nonresponders (n = 20) (P =.001), but change was similar after LVAD (P =.235). Preimplantation plasma DHPG levels were significantly lower in clinical responders than in nonresponders (P =.002), but the change was similar after LVAD (P =.881). There were no significant differences in plasma NE levels. Conclusions Preimplantation βARK1 and DHPG levels are differentiating factors between health-related quality of life clinical responders and nonresponders to LVAD, potentially signaling differing levels of sympathetic stimulation underlying clinical response.
KW - Adrenergic receptor kinase-1
KW - Health-related quality of life
KW - Left ventricular assist device
KW - Norepinephrine
KW - Sympathetic nervous system
UR - http://www.scopus.com/inward/record.url?scp=85067907265&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067907265&partnerID=8YFLogxK
U2 - 10.1097/JCN.0000000000000580
DO - 10.1097/JCN.0000000000000580
M3 - Article
VL - 34
SP - E1-E10
JO - Journal of Cardiovascular Nursing
JF - Journal of Cardiovascular Nursing
SN - 0889-4655
IS - 4
ER -