Serum Brain Natriuretic Peptide Concentration 60 Days After Surgery as a Predictor of Long-Term Prognosis in Patients Implanted With a Left Ventricular Assist Device

Mechanical circulatory support by a left ventricular assist device (LVAD) is used to bridge patients with advanced heart failure to transplant or as a definitive treatment. We retrospectively sought predictors of long-term outcome in a cohort of 83 patients who had undergone LVAD treatment. We subjected patients' perioperative clinical data to statistical analysis to establish parameters associated with all-cause mortality, and the cut-off values, sensitivity and specificity of those that had a statistically significant relationship with survival. Mean follow up was 717 days (standard deviation 334 days, range 17-1592 days). Fourteen patients (16.8%) died, but nine (10.8%) were weaned from support. Serum brain natriuretic peptide (BNP) concentration measured 60 days after implantation was significantly associated with all-cause mortality. The optimal BNP cut-off value to predict death during LVAD support was 322 pg/ml, with a sensitivity of 71.4% and specificity of 79.8%. Two-year survival was 92.0% in those with 60-day serum BNP concentration <322 pg/ml compared with 70.5% in those in whom it was ≧322 pg/ml (p = 0.003). The relationship between BNP and survival likely reflects recovery of native myocardial function and improvements in global health, and should assist clinicians in the on-going management of long-term LVAD therapy.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.