scholarly journals Value of SERCA2a as a Biomarker for the Identification of Patients With Advanced Heart Failure Requiring Circulatory Support

2021 ◽  
Author(s):  
Meryem Ezzitouny ◽  
Esther Roselló Lletí ◽  
Manuel Portolés ◽  
Ignacio Sánchez Lázaro ◽  
Miguel Angel Arnau Vives ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sarcoplasmic Reticulum ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Mechanical Circulatory Support ◽  
Area Under The Curve ◽  
Circulatory Support ◽  
Bridge To Recovery ◽  
Blood Samples ◽  
Cytoplasmic Transport

Abstract Background: Heart failure (HF) alters the nucleo-cytoplasmic transport of cardiomyocytes and reduces SERCA2a levels, essential for intracellular calcium homeostasis. We consider in this study whether the molecules involved in these processes can differentiate those patients with advanced HF and the need for mechanical circulatory support (MCS) as a bridge to recovery or urgent heart transplantation from those clinically stable and who are transplanted in an elective code. Material and method: Blood samples from patients with advanced HF were analyzed by ELISA and the plasma levels of Importin5, Nucleoporin153 kDa, RanGTPase-Activiting Protein 1 and sarcoplasmic reticulum Ca2 + ATPase were compared among patients that need MCS and patients without MCS. Results: SERCA2a showed significantly lower levels in patients who had MCS compared to those who did not require it (0.501 ± 0.530 ng / mL and 1,123 ± 0.661 ng / mL p = 0.01, respectively). By constructing the ROC curve with the SERCA2a values ​​(area under the curve of 0.812 ± 0.085, with a p of 0.004 and a 95% confidence interval between 0.646 and 0.979), we have established a cut-off point of 0.84 ng / mL with sensitivity of 92%, specificity of 62%, negative predictive value of 91% and positive predictive value of 67%. Conclusion: Patients with advanced HF and need for MCS have significantly lower levels of SERCA2a than stable patients without need for MCS. More studies are needed to validate these results. Trial registration: retrospectively registered

scholarly journals Value of SERCA2a as a Biomarker for the Identification of Patients with Heart Failure Requiring Circulatory Support

2021 ◽  
Vol 11 (11) ◽  
pp. 1122
Author(s):  
Meryem Ezzitouny ◽  
Esther Roselló-Lletí ◽  
Manuel Portolés ◽  
Ignacio Sánchez-Lázaro ◽  
Miguel Ángel Arnau-Vives ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sarcoplasmic Reticulum ◽  
Heart Transplantation ◽  
Predictive Value ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Bridge To Recovery ◽  
Blood Samples ◽  
Cytoplasmic Transport ◽  
Patients With Heart Failure

Background: Heart failure (HF) alters the nucleo-cytoplasmic transport of cardiomyocytes and reduces SERCA2a levels, essential for intracellular calcium homeostasis. We consider in this study whether the molecules involved in these processes can differentiate those patients with advanced HF and the need for mechanical circulatory support (MCS) as a bridge to recovery or urgent heart transplantation from those who are clinically stable and who are transplanted in an elective code. Material and method: Blood samples from 29 patients with advanced HF were analysed by ELISA, and the plasma levels of Importin5, Nucleoporin153 kDa, RanGTPase-Activating Protein 1 and sarcoplasmic reticulum Ca2+ ATPase were compared between patients requiring MCS and those patients without a MCS need prior to heart transplantation. Results: SERCA2a showed significantly lower levels in patients who had MCS compared to those who did not require it (0.501 ± 0.530 ng/mL vs. 1.123 ± 0.661 ng/mL; p = 0.01). A SERCA2a cut-off point of 0.84 ng/mL (AUC 0.812 ± 0.085, 95% CI: 0.646–0.979; p = 0.004) provided a 92% sensitivity, 62% specificity, 91% negative predictive value and 67% positive predictive value. Conclusions: In this cohort, patients with advanced HF and a need for MCS have shown significantly lower levels of SERCA2a as compared to stable patients without a need for MCS prior to heart transplantation. This is a small study with preliminary findings, and larger-powered dedicated studies are required to confirm and validate these results.

scholarly journals Successful experience with Levitronix PediVAS for management of acute heart failure after Fontan surgery

Open Medicine ◽  
2012 ◽  
Vol 7 (4) ◽  
pp. 529-532 ◽  
Author(s):  
Laurynas Bezuska ◽  
Virgilijus Lebetkevicius ◽  
Kestutis Lankutis ◽  
Virgilijus Tarutis
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Mechanical Circulatory Support ◽  
Pediatric Population ◽  
Circulatory Support ◽  
Bridge To Recovery ◽  
Short Term ◽  
Left Heart Bypass ◽  
Golden Standard ◽  
Fontan Surgery

AbstractAn extracorporeal membrane oxygenation was long a golden standard in the pediatric population with acute cardiac failure for short-term mechanical circulatory support. It gives the limited availability of pediatric-sized pumps and the outcomes remain disproportionately poor. The Levitronix PediVAS system (Levitronix LLC, Waltham, MA) offers expanded options for short-term support for this population. We report our experience with the successful use of the PediVAS (left heart bypass) in the 3-year-old male patient as a bridge to recovery after Fontan surgery in acute heart failure. Short-term circulatory support with the Levitronix PediVAS has proven to be a less invasive, safe, and effective for our pediatric patient.

Chronic Mechanical Circulatory Support for Patients with End-stage Heart Failure as a Definitive Treatment Option

2010 ◽  
Vol 6 (4) ◽  
pp. 22
Author(s):  
Patrycja Ganslmeier ◽  
Christof Schmid ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Definitive Treatment ◽  
Circulatory Support ◽  
Randomized Evaluation ◽  
Fda Approval ◽  
Cerebrovascular Events ◽  
Device Placement ◽  
End Stage Heart Failure ◽  
End Stage

Mechanical circulatory support for end-stage heart failure has become routine and is now increasingly used as definitive treatment. Several small devices qualify for this purpose, but only a few have gained US Food and Drug Administration (FDA) approval as yet. Several studies, including the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study, the Investigation of Non-transplant-Eligible Patients Who Are Inotrope Dependent (INTrEPID) and the HeartMate (HM) II trial have confirmed a significantly improved quality of life and functional capacity after device placement. However, cerebrovascular events, infection and device malfunction still pose a considerable risk to patients and hinder widespread use.

scholarly journals Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 468
Author(s):  
Kyle D. Hope ◽  
Priya N. Bhat ◽  
William J. Dreyer ◽  
Barbara A. Elias ◽  
Jaime L. Jump ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Heart Transplantation ◽  
Ventricular Assist Device ◽  
Mechanical Circulatory Support ◽  
Pediatric Palliative Care ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Patients With Heart Failure

Heart failure is a life-changing diagnosis for a child and their family. Pediatric patients with heart failure experience significant morbidity and frequent hospitalizations, and many require advanced therapies such as mechanical circulatory support and/or heart transplantation. Pediatric palliative care is an integral resource for the care of patients with heart failure along its continuum. This includes support during the grief of a new diagnosis in a child critically ill with decompensated heart failure, discussion of goals of care and the complexities of mechanical circulatory support, the pensive wait for heart transplantation, and symptom management and psychosocial support throughout the journey. In this article, we discuss the scope of pediatric palliative care in the realm of pediatric heart failure, ventricular assist device (VAD) support, and heart transplantation. We review the limited, albeit growing, literature in this field, with an added focus on difficult conversation and decision support surrounding re-transplantation, HF in young adults with congenital heart disease, the possibility of destination therapy VAD, and the grimmest decision of VAD de-activation.

scholarly journals Can mechanical circulatory support be an effective treatment for HFpEF patients?

2021 ◽  
Author(s):  
Einar Gude ◽  
Arnt E. Fiane
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Cavity ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Mechanical Pressure ◽  
Entry Points

AbstractHeart failure with preserved ejection fraction (HFpEF) is increasing in prevalence and represents approximately 50% of all heart failure (HF) patients. Patients with this complex clinical scenario, characterized by high filling pressures, and reduced cardiac output (CO) associated with progressive multi-organ involvement, have so far not experienced any significant improvement in quality of life or survival with traditional HF treatment. Left ventricular assist devices (LVAD) have offered a new treatment alternative in terminal heart failure patients with reduced ejection fraction (HFrEF), providing a unique combination of significant pressure and volume unloading together with an increase in CO. The small left ventricular cavity in HFpEF patients challenges left-sided pressure unloading, and new anatomical entry points need to be explored for mechanical pressure and volume unloading. Optimized and pressure/volume-adjusted mechanical circulatory support (MCS) devices for HFrEF patients may conceivably be customized for HFpEF anatomy and hemodynamics. We have developed a long-term MCS device for HFpEF patients with atrial unloading in a pulsed algorithm, leading to a significant reduction of filling pressure, maintenance of pulse pressure, and increase in CO demonstrated in animal testing. In this article, we will discuss HFpEF pathology, hemodynamics, and the principles behind our novel MCS device that may improve symptoms and prognosis in HFpEF patients. Data from mock-loop hemolysis studies, acute, and chronic animal studies will be presented.

scholarly journals Changes in Lipid Profile Following Durable Mechanical Circulatory Support: Confirming the “Lipid Paradox” in Heart Failure

2016 ◽  
Vol 35 (4) ◽  
pp. S387-S388
Author(s):  
K.S. Telukuntla ◽  
T.C. Hanff ◽  
E.W. Grandin ◽  
J.A. Mazurek ◽  
J.L. Howard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Lipid Profile ◽  
Mechanical Circulatory Support ◽  
Circulatory Support
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