Hypertension

an unstudied potential risk factor for adverse outcomes during continuous flow ventricular assist device support

Lauren T. Wasson, Melana Yuzefpolskaya, Michiyori Wakabayashi, Hiroo Takayama, Yoshifumi Naka, Nir Uriel, Ulrich P. Jorde, Ryan T. Demmer, Paolo C. Colombo

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

In end-stage heart failure, left ventricular assist devices (LVADs) represent an exciting new frontier in which post-device implantation survival approaches that of heart transplant. However, expansion of this technology is still limited by complications that impact morbidity and mortality. Thus, it is essential to identify and optimize modifiable predictors of poor outcomes. One such predictor may be hypertension (HTN). Not only may chronic HTN as a traditional cardiovascular risk factor be present during long-term LVAD support, but HTN may also contribute to device malfunction or device-associated complications. Although current guidelines identify blood pressure (BP) control as important to outpatient continuous flow (CF) LVAD management, there is no evidence base to support these guidelines. Indeed, our comprehensive literature search did not identify any studies that evaluated post-device implantation HTN as a potential predictor of adverse CF-LVAD outcomes. HTN among CF-LVAD patients is likely a relatively unstudied factor because of difficulties using standard noninvasive techniques to measure BP in the setting of reduced pulsatile flow. Fortunately, recent research has elucidated the meaning of Doppler BP measurements and validated a slow-cuff deflation system for BP measurements in the setting of CF-LVAD support. Therefore, CF-LVAD researchers and clinicians may (1) consider potential mechanisms relating HTN to poor outcomes, (2) realize that HTN management is a stated goal despite scarce evidence, and (3) utilize the new reliable and valid methods for outpatient BP measurement that make research and management possible. It is critical and now feasible that research on HTN in the CF-LVAD patient population move forward.

Original languageEnglish (US)
Pages (from-to)317-322
Number of pages6
JournalHeart Failure Reviews
Volume20
Issue number3
DOIs
StatePublished - May 1 2015
Externally publishedYes

Fingerprint

Heart-Assist Devices
Hypertension
Blood Pressure
Equipment and Supplies
Outpatients
Research
Guidelines
Pulsatile Flow
Heart Failure
Research Personnel
Technology
Morbidity
Transplants
Survival
Mortality

Keywords

  • Blood pressure
  • Hypertension
  • Left ventricular assist devices
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Wasson, L. T., Yuzefpolskaya, M., Wakabayashi, M., Takayama, H., Naka, Y., Uriel, N., ... Colombo, P. C. (2015). Hypertension: an unstudied potential risk factor for adverse outcomes during continuous flow ventricular assist device support. Heart Failure Reviews, 20(3), 317-322. https://doi.org/10.1007/s10741-014-9458-3

Hypertension : an unstudied potential risk factor for adverse outcomes during continuous flow ventricular assist device support. / Wasson, Lauren T.; Yuzefpolskaya, Melana; Wakabayashi, Michiyori; Takayama, Hiroo; Naka, Yoshifumi; Uriel, Nir; Jorde, Ulrich P.; Demmer, Ryan T.; Colombo, Paolo C.

In: Heart Failure Reviews, Vol. 20, No. 3, 01.05.2015, p. 317-322.

Research output: Contribution to journalArticle

Wasson, LT, Yuzefpolskaya, M, Wakabayashi, M, Takayama, H, Naka, Y, Uriel, N, Jorde, UP, Demmer, RT & Colombo, PC 2015, 'Hypertension: an unstudied potential risk factor for adverse outcomes during continuous flow ventricular assist device support', Heart Failure Reviews, vol. 20, no. 3, pp. 317-322. https://doi.org/10.1007/s10741-014-9458-3
Wasson, Lauren T. ; Yuzefpolskaya, Melana ; Wakabayashi, Michiyori ; Takayama, Hiroo ; Naka, Yoshifumi ; Uriel, Nir ; Jorde, Ulrich P. ; Demmer, Ryan T. ; Colombo, Paolo C. / Hypertension : an unstudied potential risk factor for adverse outcomes during continuous flow ventricular assist device support. In: Heart Failure Reviews. 2015 ; Vol. 20, No. 3. pp. 317-322.
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