B-type Natriuretic Peptide Before Discharge after Left Ventricular Assist Device Implantation Is Associated With Subsequent Hospitalization due to Cardiac Causes

Background: Although the level of B-type natriuretic peptide (BNP) before discharge is a well-known predictor for prognosis among chronic heart failure patients, its impact on patients with implantable left ventricular assist device (iLVAD) is still uncertain. Methods: Those who received iLVAD implantation between 2008 and 2016 in our institute and have been followed up for >1 year were enrolled. Those who were converted from extracorporeal VAD, who deceased, or received heart transplantation within 1 year after iLVAD implantation were excluded. Endpoint was re-hospitalization due to cardiac causes (arrhythmia, right ventricular failure: RVF, aortic insufficiency). Results: Fifty-six patients (male: 43, age 40.0 ± 13.4 years) were enrolled. Follow-up period was 804 ± 309 days. Thirteen patients were re-hospitalized due to cardiac causes (arrhythmia 8, RVF 2, aortic insufficiency 1, other causes 2) during follow-up period. Between event (+) and event (-) group, there were no significant differences about pre-discharge laboratory data, echocardiographic and hemodynamic parameters except left ventricular ejection fraction (LVEF) and BNP (LVEF: 12.2 ± 6.1 vs 17.3 ± 10.1%, P < .05 and BNP: 518.2 ± 439.4 vs 283.0 ± 225.8 pg/mL, P < .05). From Cox-hazard analysis using the duration to first re-hospitalization due to cardiac causes, pre-discharge BNP was a significant predictor (P = .009, hazard ratio = 1.002). Conclusions: Higher BNP just before hospital discharge after iLVAD implantation is associated with subsequent re-hospitalization due to cardiac causes.