Neurocognitive function in destination therapy patients receiving continuous-flow vs pulsatile-flow left ventricular assist device support
Background The HeartMate II (Thoratec Corp, Pleasanton, CA) continuous-flow left ventricular assist device (LVAD) improved survival in destination therapy (DT) patients during a randomized trial compared with pulsatile-flow LVADs. This study documented changes in cognitive performance in DT patients...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2012, Vol.31 (1), p.27-36 |
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| creator | Petrucci, Ralph J., EdD Rogers, Joseph G., MD Blue, Laura, NP Gallagher, Colleen, BSN Russell, Stuart D., MD Dordunoo, Dzifa, MSN Jaski, Brian E., MD Chillcott, Suzanne, RN Sun, Benjamin, MD Yanssens, Tammy L., BSN Tatooles, Antone, MD Koundakjian, Lalig, MPH Farrar, David J., PhD Slaughter, Mark S., MD |
| description | Background The HeartMate II (Thoratec Corp, Pleasanton, CA) continuous-flow left ventricular assist device (LVAD) improved survival in destination therapy (DT) patients during a randomized trial compared with pulsatile-flow LVADs. This study documented changes in cognitive performance in DT patients from that trial to determine if there were differences between continuous-flow and pulsatile-flow support. Methods Data were collected in a sub-study from 96 HeartMate II continuous-flow and 30 HeartMate XVE pulsatile-flow LVAD patients from 12 of the 35 trial sites that followed the same serial neurocognitive (NC) testing protocol at 1, 3, 6, 12, and 24 months after LVAD implantation. Spatial perception, memory, language, executive functions, and processing speed were the domains assessed with 10 standard cognitive measures. Differences over time and between LVAD type were evaluated with linear mixed-effects modeling. Results From 1 to 24 months after LVAD implantation, changes in NC functions were stable or showed improvement in all domains, and there were no differences between the continuous-flow and pulsatile-flow groups. Data at 24 months were only available from patients with the continuous-flow LVAD due to the limited durability of the HeartMate XVE device. There was no decline in any NC domain over the time of LVAD support. Missing data not collected from patients who died could have resulted in a bias toward inflated study results. Conclusions The NC performance of advanced heart failure patients supported with continuous-flow and pulsatile-flow LVADs shows stabilization or improvement during support for up to 24 months. |
| doi_str_mv | 10.1016/j.healun.2011.10.012 |
| format | Article |
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This study documented changes in cognitive performance in DT patients from that trial to determine if there were differences between continuous-flow and pulsatile-flow support. Methods Data were collected in a sub-study from 96 HeartMate II continuous-flow and 30 HeartMate XVE pulsatile-flow LVAD patients from 12 of the 35 trial sites that followed the same serial neurocognitive (NC) testing protocol at 1, 3, 6, 12, and 24 months after LVAD implantation. Spatial perception, memory, language, executive functions, and processing speed were the domains assessed with 10 standard cognitive measures. Differences over time and between LVAD type were evaluated with linear mixed-effects modeling. Results From 1 to 24 months after LVAD implantation, changes in NC functions were stable or showed improvement in all domains, and there were no differences between the continuous-flow and pulsatile-flow groups. Data at 24 months were only available from patients with the continuous-flow LVAD due to the limited durability of the HeartMate XVE device. There was no decline in any NC domain over the time of LVAD support. Missing data not collected from patients who died could have resulted in a bias toward inflated study results. Conclusions The NC performance of advanced heart failure patients supported with continuous-flow and pulsatile-flow LVADs shows stabilization or improvement during support for up to 24 months.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2011.10.012</identifier><identifier>PMID: 22153550</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiology. Vascular system ; Cognition - physiology ; destination therapy ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Female ; Follow-Up Studies ; Heart Failure - physiopathology ; Heart Failure - psychology ; Heart Failure - therapy ; Heart Transplantation ; Heart-Assist Devices ; Humans ; Intensive care medicine ; left ventricular assist device ; LVAD ; Male ; Medical sciences ; Memory - physiology ; Middle Aged ; neurocognitive function ; Prosthesis Design ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Treatment Outcome</subject><ispartof>The Journal of heart and lung transplantation, 2012, Vol.31 (1), p.27-36</ispartof><rights>International Society for Heart and Lung Transplantation</rights><rights>2012 International Society for Heart and Lung Transplantation</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c558t-de07cd8c09b2e047a7237591b65b1a2dafa2c40dbdbbeff37b61a7d5d68b4f6f3</citedby><cites>FETCH-LOGICAL-c558t-de07cd8c09b2e047a7237591b65b1a2dafa2c40dbdbbeff37b61a7d5d68b4f6f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053249811011922$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25631785$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22153550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Petrucci, Ralph J., EdD</creatorcontrib><creatorcontrib>Rogers, Joseph G., MD</creatorcontrib><creatorcontrib>Blue, Laura, NP</creatorcontrib><creatorcontrib>Gallagher, Colleen, BSN</creatorcontrib><creatorcontrib>Russell, Stuart D., MD</creatorcontrib><creatorcontrib>Dordunoo, Dzifa, MSN</creatorcontrib><creatorcontrib>Jaski, Brian E., MD</creatorcontrib><creatorcontrib>Chillcott, Suzanne, RN</creatorcontrib><creatorcontrib>Sun, Benjamin, MD</creatorcontrib><creatorcontrib>Yanssens, Tammy L., BSN</creatorcontrib><creatorcontrib>Tatooles, Antone, MD</creatorcontrib><creatorcontrib>Koundakjian, Lalig, MPH</creatorcontrib><creatorcontrib>Farrar, David J., PhD</creatorcontrib><creatorcontrib>Slaughter, Mark S., MD</creatorcontrib><title>Neurocognitive function in destination therapy patients receiving continuous-flow vs pulsatile-flow left ventricular assist device support</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>Background The HeartMate II (Thoratec Corp, Pleasanton, CA) continuous-flow left ventricular assist device (LVAD) improved survival in destination therapy (DT) patients during a randomized trial compared with pulsatile-flow LVADs. This study documented changes in cognitive performance in DT patients from that trial to determine if there were differences between continuous-flow and pulsatile-flow support. Methods Data were collected in a sub-study from 96 HeartMate II continuous-flow and 30 HeartMate XVE pulsatile-flow LVAD patients from 12 of the 35 trial sites that followed the same serial neurocognitive (NC) testing protocol at 1, 3, 6, 12, and 24 months after LVAD implantation. Spatial perception, memory, language, executive functions, and processing speed were the domains assessed with 10 standard cognitive measures. Differences over time and between LVAD type were evaluated with linear mixed-effects modeling. Results From 1 to 24 months after LVAD implantation, changes in NC functions were stable or showed improvement in all domains, and there were no differences between the continuous-flow and pulsatile-flow groups. Data at 24 months were only available from patients with the continuous-flow LVAD due to the limited durability of the HeartMate XVE device. There was no decline in any NC domain over the time of LVAD support. Missing data not collected from patients who died could have resulted in a bias toward inflated study results. Conclusions The NC performance of advanced heart failure patients supported with continuous-flow and pulsatile-flow LVADs shows stabilization or improvement during support for up to 24 months.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cognition - physiology</subject><subject>destination therapy</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - psychology</subject><subject>Heart Failure - therapy</subject><subject>Heart Transplantation</subject><subject>Heart-Assist Devices</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>left ventricular assist device</subject><subject>LVAD</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Memory - physiology</subject><subject>Middle Aged</subject><subject>neurocognitive function</subject><subject>Prosthesis Design</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Treatment Outcome</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFksuOFSEQhjtG41z0DYxhY1z1kUvTl42JmYyOyUQX6prQUMxw5EALTZvzCj61tH3UxI0roPJVFfX_VVXPCN4RTNpX-909SJf9jmJCSmiHCX1QnRPOu5oR0j0sd8xZTZuhP6suUtpjjCnj9HF1RinhjHN8Xv34ADkGFe68ne0CyGSvZhs8sh5pSLP18tdzvocopyOayhP8nFAEBXax_g6p4AuWQ061ceE7WhKasksFdLBFHJgZLSUtWpWdjEimZNNcGixWAUp5mkKcn1SPjHQJnp7Oy-rL2-vPVzf17cd376_e3NaK836uNeBO6V7hYaSAm052lHV8IGPLRyKplkZS1WA96nEEY1g3tkR2muu2HxvTGnZZvdzqTjF8y2VGcbBJgXPSQxlCDIQMrG8bVshmI1UMKUUwYor2IONRECxWE8RebCaI1YQ1Wkwoac9PDfJ4AP0n6bfqBXhxAmRS0pkovbLpL8dbRrqeF-71xkGRY7EQRVJFfQXaFvlnoYP930_-LaCc9bb0_ApHSPuQoy9SCyISFVh8Whdm3RdSSpKBUvYTINnBkQ</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Petrucci, Ralph J., EdD</creator><creator>Rogers, Joseph G., MD</creator><creator>Blue, Laura, NP</creator><creator>Gallagher, Colleen, BSN</creator><creator>Russell, Stuart D., MD</creator><creator>Dordunoo, Dzifa, MSN</creator><creator>Jaski, Brian E., MD</creator><creator>Chillcott, Suzanne, RN</creator><creator>Sun, Benjamin, MD</creator><creator>Yanssens, Tammy L., BSN</creator><creator>Tatooles, Antone, MD</creator><creator>Koundakjian, Lalig, MPH</creator><creator>Farrar, David J., PhD</creator><creator>Slaughter, Mark S., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2012</creationdate><title>Neurocognitive function in destination therapy patients receiving continuous-flow vs pulsatile-flow left ventricular assist device support</title><author>Petrucci, Ralph J., EdD ; Rogers, Joseph G., MD ; Blue, Laura, NP ; Gallagher, Colleen, BSN ; Russell, Stuart D., MD ; Dordunoo, Dzifa, MSN ; Jaski, Brian E., MD ; Chillcott, Suzanne, RN ; Sun, Benjamin, MD ; Yanssens, Tammy L., BSN ; Tatooles, Antone, MD ; Koundakjian, Lalig, MPH ; Farrar, David J., PhD ; Slaughter, Mark S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c558t-de07cd8c09b2e047a7237591b65b1a2dafa2c40dbdbbeff37b61a7d5d68b4f6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cognition - physiology</topic><topic>destination therapy</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - psychology</topic><topic>Heart Failure - therapy</topic><topic>Heart Transplantation</topic><topic>Heart-Assist Devices</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>left ventricular assist device</topic><topic>LVAD</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Memory - physiology</topic><topic>Middle Aged</topic><topic>neurocognitive function</topic><topic>Prosthesis Design</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Petrucci, Ralph J., EdD</creatorcontrib><creatorcontrib>Rogers, Joseph G., MD</creatorcontrib><creatorcontrib>Blue, Laura, NP</creatorcontrib><creatorcontrib>Gallagher, Colleen, BSN</creatorcontrib><creatorcontrib>Russell, Stuart D., MD</creatorcontrib><creatorcontrib>Dordunoo, Dzifa, MSN</creatorcontrib><creatorcontrib>Jaski, Brian E., MD</creatorcontrib><creatorcontrib>Chillcott, Suzanne, RN</creatorcontrib><creatorcontrib>Sun, Benjamin, MD</creatorcontrib><creatorcontrib>Yanssens, Tammy L., BSN</creatorcontrib><creatorcontrib>Tatooles, Antone, MD</creatorcontrib><creatorcontrib>Koundakjian, Lalig, MPH</creatorcontrib><creatorcontrib>Farrar, David J., PhD</creatorcontrib><creatorcontrib>Slaughter, Mark S., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Petrucci, Ralph J., EdD</au><au>Rogers, Joseph G., MD</au><au>Blue, Laura, NP</au><au>Gallagher, Colleen, BSN</au><au>Russell, Stuart D., MD</au><au>Dordunoo, Dzifa, MSN</au><au>Jaski, Brian E., MD</au><au>Chillcott, Suzanne, RN</au><au>Sun, Benjamin, MD</au><au>Yanssens, Tammy L., BSN</au><au>Tatooles, Antone, MD</au><au>Koundakjian, Lalig, MPH</au><au>Farrar, David J., PhD</au><au>Slaughter, Mark S., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neurocognitive function in destination therapy patients receiving continuous-flow vs pulsatile-flow left ventricular assist device support</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2012</date><risdate>2012</risdate><volume>31</volume><issue>1</issue><spage>27</spage><epage>36</epage><pages>27-36</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract>Background The HeartMate II (Thoratec Corp, Pleasanton, CA) continuous-flow left ventricular assist device (LVAD) improved survival in destination therapy (DT) patients during a randomized trial compared with pulsatile-flow LVADs. This study documented changes in cognitive performance in DT patients from that trial to determine if there were differences between continuous-flow and pulsatile-flow support. Methods Data were collected in a sub-study from 96 HeartMate II continuous-flow and 30 HeartMate XVE pulsatile-flow LVAD patients from 12 of the 35 trial sites that followed the same serial neurocognitive (NC) testing protocol at 1, 3, 6, 12, and 24 months after LVAD implantation. Spatial perception, memory, language, executive functions, and processing speed were the domains assessed with 10 standard cognitive measures. Differences over time and between LVAD type were evaluated with linear mixed-effects modeling. Results From 1 to 24 months after LVAD implantation, changes in NC functions were stable or showed improvement in all domains, and there were no differences between the continuous-flow and pulsatile-flow groups. Data at 24 months were only available from patients with the continuous-flow LVAD due to the limited durability of the HeartMate XVE device. There was no decline in any NC domain over the time of LVAD support. Missing data not collected from patients who died could have resulted in a bias toward inflated study results. Conclusions The NC performance of advanced heart failure patients supported with continuous-flow and pulsatile-flow LVADs shows stabilization or improvement during support for up to 24 months.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22153550</pmid><doi>10.1016/j.healun.2011.10.012</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of heart and lung transplantation, 2012, Vol.31 (1), p.27-36 |
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| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiology. Vascular system Cognition - physiology destination therapy Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Female Follow-Up Studies Heart Failure - physiopathology Heart Failure - psychology Heart Failure - therapy Heart Transplantation Heart-Assist Devices Humans Intensive care medicine left ventricular assist device LVAD Male Medical sciences Memory - physiology Middle Aged neurocognitive function Prosthesis Design Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Treatment Outcome |
| title | Neurocognitive function in destination therapy patients receiving continuous-flow vs pulsatile-flow left ventricular assist device support |
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