Changes in Dynamics of Cardiac Biomarkers Features During VAD Support

Valeriya Krachak, Liana Shestakova, Dmitry Krachak, Marina Bushkevich, Roman Yarosh, Natalia Pertrovich, Olga Lubimova, Marina Koliadko, Yuriy Ostrovskiy

RSPC Cardiology, Minsk, Belarus

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – A

Abstract

Objective: The purpose of this study was to evaluate changes of cardiac biomarkers in a group of patients with ventricular assist devices (VAD) as “bridge to heart transplantation” strategy.

Methods: In this study we include 18 patients with implanted VAD. The mean age of the patients was 47,1 ± 12,9 years, 99% of them were men, with ischemic cardiomyopathy (ICM) in 50%, dilated cardiomyopathy (DCM) in 43,75% and giant cell myocarditis (GM) in 6,25%. VADs were implanted for 213,5 (118,5:370) days and then heart transplantation (HTx) was performed. In this study measurements of BNP, NT-proBNP, ST2 were performed sequentially before and on VAD support.

Results: Baseline features of BNP and NT-proBNP before VAD implantation were 1950±1025 pg/ml and 4673±1100 pg/ml. During mechanical support (MCS) patients had positive dynamics of cardiomarkers before HTx, BNP decreased to 513±259 pg/ml (p<0,01) and NT-proBNP – to 3526±280 pg/ml (p˃0,05). ST2 is a marker of cardiomyocyte stress and fibrosis which used for risk stratification in heart failure. Baseline ST2 features were 33,6 (20:172) ng/ml and also during MCS decreased to 22,1 (11:27,9) ng/ml (p˂0,05). All of these patients had no hospital mortality. ICU staying after HTx was 7,9±2,6 days, step-down care staying - 25,3±14,4 days. One year survival - 88,9 %.

Conclusions: VAD support results in a significant drop in BNP, NT-proBNP, ST2 levels close to normal, which allowed us to performed HTx.