Objective:
Evaluate the prognostic implications of N-terminal Pro-B-type Natriuretic Peptide measurements in ambulatory patients with continuous flow left ventricle assist devices (CFLVAD).
Methods:
We performed a retrospective study of consecutive patients that had an LVAD implantation at our institution and were discharged from their index hospitalization.
Results:
Between January 31
st
, 2006 and August 21
st
, 2019, 139 patients received a continuous flow left ventricle assist device implant at our institution and survived beyond their index hospitalization. 127 patients (56.2±12.5 years, 78.7 % male) had NT pro BNP measured at 1- and 3-months post discharge in ambulatory settings. The median (IQR) NT-pro BNP levels were 1661 pg/mL (921-2558 pg/mL) at 1 month and 1094 pg/mL (673-2089 pg/mL) at 3 months post discharge. After a median follow up of 17 months, a total of 53 (41.7%) incidents event occurred. Of these, 37 (69.8%) were heart failure hospitalizations and 16 (30.2%) were deaths. For each 1000-unit increase in NT-pro BNP level at 3 months, there was a 17% increase in the risk of heart failure hospitalization or death (HR=1.17, 95% CI=1.04-1.32, p=0.007)). Also, for each 1000-unit decline in NT-pro BNP level between the 1
st
and 3
rd
months, there was an 11% decrease in the risk of heart failure hospitalization or death (HR=0.89, 95% CI=0.77-0.98, p=0.04).
Conclusion:
In ambulatory patients with CFLVAD, increase in NT pro BNP value from one to three months is associated with a significantly increased risk of heart failure hospitalization and death.
Plasma B-Type Natriuretic Peptide Levels in Ambulatory Patients With Established Chronic Symptomatic Systolic Heart Failure
