4.2 Article

Isolated left ventricular assist device implantation produces variable changes to patient body mass index

期刊

ARTIFICIAL ORGANS
卷 46, 期 8, 页码 1597-1607

出版社

WILEY
DOI: 10.1111/aor.14226

关键词

bariatric surgery; body mass index; class 2 obesity; class 3 obesity; destination therapy; heart failure; left ventricle assist device; mechanical circulatory support; morbid obesity; obesity; transplant; weight loss

资金

  1. Department of Surgery, Division of Cardiothoracic Surgery at the Medical College of Wisconsin, Milwaukee, WI
  2. NIH/NHLBI [K08 HL14000]
  3. American College of Surgeons George Clowes Career Development Award
  4. Medical College of Wisconsin Research Affairs Committee Award
  5. Medical College of Wisconsin Cardiovascular Center Michael Keelan Jr. MD Research Foundation Award

向作者/读者索取更多资源

This study examined BMI changes in LVAD patients and found that weight changes may impact transplant candidacy, with higher BMI groups potentially benefiting from targeted weight-loss interventions.
Background Body mass index (BMI) is an important consideration for transplant-eligible left ventricular assist device (LVAD) recipients. LVAD therapy's impact on BMI is unclear. We evaluated BMI changes in patients who underwent LVAD implantation. The association between these patients' BMI and the transplant was studied. Methods This was a retrospective cohort study of patients who underwent LVAD implantation between January 1, 2012 and December 31, 2018 at our institution. Patients were stratified by preoperative BMI (kg/m(2)) into four groups: <30, 30-34.9, 34.9-39.9, and >= 40. BMI data were collected at 12 and 6 months prior to implantation, time of implantation, and 3- and 6- months postimplantation. Results A total of 107 patients underwent LVAD implantation at our institution. Data were available for 80 patients. Baseline characteristics included a mean age of 56.0 years, 69% male, and a mean implant BMI of 29.9 +/- 6.8 kg/m(2). The mean BMI (kg/m(2)) for each of the BMI (kg/m(2)) groups <30, 30-34.9, 35-39.9, and >= 40 (n = 60, 25, 12, and 10, respectively) was 25.1, 32.5, 36.8, and 43.8, respectively. There was no consistent pattern with weight change across differing implant BMIs. No patient with a BMI of <30 gained sufficient weight to impact transplant candidacy. Twenty-three percent of patients with a BMI of 30-34.9 kg/m(2), 60% of patients with a BMI of 35-39.9 kg/m(2), and 87.5% of patients with a BMI of >= 40 kg/m(2) had a 6-month BMI potentially affecting transplant. Conclusions Associated weight changes during LVAD support may significantly impact transplant candidacy. Higher BMI groups may benefit from multimodal and multidisciplinary targeted weight-loss interventions.

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