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The Inflammatory Response to Ventricular Assist Devices

Gemma Radley, Ina Laura Pieper, Sabrina Ali, Farah Bhatti, Cathy Thornton Orcid Logo

Frontiers in Immunology, Volume: 9

Swansea University Author: Cathy Thornton Orcid Logo

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DOI (Published version): 10.3389/fimmu.2018.02651

Abstract

The therapeutic use of ventricular assist devices (VADs) for end-stage heart failure (HF) patients who are ineligible for transplant has increased steadily in the last decade. In parallel, improvements in VAD design have reduced device size, cost, and device-related complications. These complication...

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Published in: Frontiers in Immunology
ISSN: 1664-3224
Published: 2018
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URI: https://cronfa.swan.ac.uk/Record/cronfa45954
first_indexed 2018-11-16T20:18:30Z
last_indexed 2019-01-14T14:00:20Z
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spelling 2019-01-14T12:34:34.0574005 v2 45954 2018-11-16 The Inflammatory Response to Ventricular Assist Devices c71a7a4be7361094d046d312202bce0c 0000-0002-5153-573X Cathy Thornton Cathy Thornton true false 2018-11-16 MEDS The therapeutic use of ventricular assist devices (VADs) for end-stage heart failure (HF) patients who are ineligible for transplant has increased steadily in the last decade. In parallel, improvements in VAD design have reduced device size, cost, and device-related complications. These complications include infection and thrombosis which share underpinning contribution from the inflammatory response and remain common risks from VAD implantation. An added and underappreciated difficulty in designing a VAD that supports heart function and aids the repair of damaged myocardium is that different types of HF are accompanied by different inflammatory profiles that can affect the response to the implanted device. Circulating inflammatory markers and changes in leukocyte phenotypes receive much attention as biomarkers for mortality and disease progression. However, they are seldom used to monitor progress during and outcomes from VAD therapy or during the design phase for new devices. Even the partial reversal of heart damage associated with heart failure is a desirable outcome from VAD use. Therefore, improved understanding of the interplay between VADs and the recipient’s inflammatory response would potentially increase their uptake, improve patient lives, and fuel research related to other blood-contacting medical devices. Here we provide a review of what is currently known about inflammation in heart failure and how this inflammatory profile is altered in heart failure patients receiving VAD therapy. Journal Article Frontiers in Immunology 9 1664-3224 Heart failure; Ventricular Assist Devices; Inflammation; Cytokines; Leukocytes 15 11 2018 2018-11-15 10.3389/fimmu.2018.02651 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University 2019-01-14T12:34:34.0574005 2018-11-16T13:37:20.1788946 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Gemma Radley 1 Ina Laura Pieper 2 Sabrina Ali 3 Farah Bhatti 4 Cathy Thornton 0000-0002-5153-573X 5 0045954-06122018160258.pdf 45954.pdf 2018-12-06T16:02:58.3400000 Output 962756 application/pdf Version of Record true 2018-12-05T00:00:00.0000000 Released under the terms of a Creative Commons Attribution License (CC-BY). true eng
title The Inflammatory Response to Ventricular Assist Devices
spellingShingle The Inflammatory Response to Ventricular Assist Devices
Cathy Thornton
title_short The Inflammatory Response to Ventricular Assist Devices
title_full The Inflammatory Response to Ventricular Assist Devices
title_fullStr The Inflammatory Response to Ventricular Assist Devices
title_full_unstemmed The Inflammatory Response to Ventricular Assist Devices
title_sort The Inflammatory Response to Ventricular Assist Devices
author_id_str_mv c71a7a4be7361094d046d312202bce0c
author_id_fullname_str_mv c71a7a4be7361094d046d312202bce0c_***_Cathy Thornton
author Cathy Thornton
author2 Gemma Radley
Ina Laura Pieper
Sabrina Ali
Farah Bhatti
Cathy Thornton
format Journal article
container_title Frontiers in Immunology
container_volume 9
publishDate 2018
institution Swansea University
issn 1664-3224
doi_str_mv 10.3389/fimmu.2018.02651
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description The therapeutic use of ventricular assist devices (VADs) for end-stage heart failure (HF) patients who are ineligible for transplant has increased steadily in the last decade. In parallel, improvements in VAD design have reduced device size, cost, and device-related complications. These complications include infection and thrombosis which share underpinning contribution from the inflammatory response and remain common risks from VAD implantation. An added and underappreciated difficulty in designing a VAD that supports heart function and aids the repair of damaged myocardium is that different types of HF are accompanied by different inflammatory profiles that can affect the response to the implanted device. Circulating inflammatory markers and changes in leukocyte phenotypes receive much attention as biomarkers for mortality and disease progression. However, they are seldom used to monitor progress during and outcomes from VAD therapy or during the design phase for new devices. Even the partial reversal of heart damage associated with heart failure is a desirable outcome from VAD use. Therefore, improved understanding of the interplay between VADs and the recipient’s inflammatory response would potentially increase their uptake, improve patient lives, and fuel research related to other blood-contacting medical devices. Here we provide a review of what is currently known about inflammation in heart failure and how this inflammatory profile is altered in heart failure patients receiving VAD therapy.
published_date 2018-11-15T04:40:24Z
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