The effect on microvascular function of combined mechanical circulatory support and pharmacological therapy during induction of myocardial recovery

LVAD therapy significantly improved LV ejection fraction (EF%: 21% 3.8% to 37% 11.39%) and cardiac output (CO: 3.49 1.3 to 7.3 0.2 l/m) in all patients with intergroup differences; other parameters were not appreciably altered. After an initial precipitous decline, BNP, ET-1 and NOR serum levels remained significantly lower in all patients. BNP and ET-1 exhibited a striking parallelism. Both manifested a bi-phasic tendency and their trendlines revealed an inverse proportionality to corresponding EF% measurements. In contrast, no discernible pattern could be seen with AT II. Several patients (n 5) exhibited either no attenuation or an increase in BNP plasma levels. All were ICMP patients; most (4/5) suffered from right heart failure postoperatively and showed decreased or unchanged EF%. Conclusions: Plasma BNP and ET-1 levels strongly correlate with the status of LV function. Alterations in these levels during LVAD support may be of potential use as a therapeutic indicator.