Hirokazu Akashi, Tomoko S. Kato, Khurram Shahzad, Mario C. Deng, Donna M. Mancini, Taira Yamamoto, Atsushi Amano, Hiroo Takayama and Yoshifumi Naka
Objective: Differences in B-type natriuretic peptide (BNP) values before and after left ventricular assist device (LVAD) surgery were evaluated as a predictor of survival after the surgery. Background: The impact of reduction of pre-operative BNP values, following LVAD surgery, on post-operative survival in heart failure (HF) patients is not known. Methods: Among a total of 287 patients who underwent LVAD surgery at Columbia University Medical Center between 2000 and 2010, 72 patients who had plasma BNP measurements at both 1 week before and 1 month after surgery were enrolled. Patients were divided into 2 groups according to % change of BNP value through surgery (% BNP change): greater (group A) or less than (group B) the median % BNP change. Result: Neither pre-operative nor post-operative BNP values were significantly correlated with post-surgical survival. The % BNP change was significantly correlated with post-surgical survival. Clinical characteristics, laboratory examination, and hemodynamics before and after surgery were not different between the two groups. Group A patients showed significantly better survival at 100 and 200 post-surgical days compared to group B (86.1 % vs. 74.6 %, 80.6 % vs. 54.5%, p=0.0399, respectively). Conclusion: The % BNP change could predict survival after LVAD surgery.