Association of Pulsatility with Gastrointestinal Bleeding in a Cohort of HeartMate II Recipients

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Adam L EdwardsShajan Peter

Abstract

Gastrointestinal bleeding (GIB) is common in patients with continuous-flow left ventricular assist devices (CF-LVADs) possibly because of changes in blood flow. We aimed to test the hypothesis that a low pulsatility index (PI) is associated with an increased hazard of overt GIB in patients with CF-LVADs. We conducted a retrospective cohort study of patients who had a HeartMate II (HMII) CF-LVAD implanted at our center. The study end-point was the first overt GIB causing or occurring during a hospitalization between 6 days and 6 months after HMII implantation. HMII PI was recorded at 48 hours and at 1, 3, and 6 month intervals after implantation. We analyzed the associations of PI and clinical variables with the hazard of overt GIB. Ninety-five patients met eligibility criteria. PI ranged from 2.5 to 5.9 (low PI < 4.15 and high PI ≥ 4.15 on the basis of receiver operating characteristic curve analysis). Seventeen (18%) patients experienced overt GIB. In a multivariable model, only lower baseline hemoglobin was a significant predictor of an increased hazard of overt GIB. After adjusting for the baseline hemoglobin, low PI was independently associated with an increased hazard of overt GIB in our cohort of HMII recipients.

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Citations

Apr 12, 2018·The New England Journal of Medicine·Mark H Drazner
Jun 15, 2018·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Jennifer A Cowger, Keyur B Shah
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Jan 14, 2022·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Armin PeivandiAngelo M Dell'Aquila

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