Abstract
Background
In patients with a continuous-flow left ventricular assist device, preimplant predictors
of poor physical performance are not well-described. We aimed to identify predictors
of inability to walk more than 300 m on 6-minute walk test (6MWT) 6 months after HeartMate
3 implantation.
Methods and Results
Using data from the European Registry of Patients Implanted With a Full Magnetically
Levitated LVAD, patients with available 6MWT at 6 months after implantation were included
(N = 194) and grouped according to 6MWT distance (6MWD) of >300 m (n = 150) or 6MWD of <300 m (n = 44). Patients walking <300 m were older (60 ± 10 vs 52 ± 12 years; P < .001), more often New York Heart Association functional class IV (63% vs 42%; P = .03), and more often had type 2 diabetes (43% vs 17%; P < .001) at implantation. Atrial fibrillation was seen in 57% in those with a 6MWT
of <300 m vs 31% in those walking longer (P < .002). Further, hemoglobin and estimated glomerular filtration rate was lower in
those walking <300 m (both P < .01). In multivariable regression analysis, independent predictors of a 6MWD of
<300 m were: atrial fibrillation (odds ratio [OR], 3.22; 95% confidence interval [CI],
1.12–8.67), older age (OR for 10-year increment, 2.81; 95% CI, 1.55–5.07), New York
Heart Association functional class IV (OR, 3.37; 95% CI, 1.27–8.98), and Interagency
Registry for Mechanically Assisted Circulatory Support profile 1 or 2 (OR, 6.53; 95%
CI, 1.92–22.19).
Conclusions
Six months after HeartMate 3 implantation, 77% of patients walked >300 meters in 6
minutes. Apart from age and measures of heart failure severity, atrial fibrillation
at implantation is an independent predictor of low 6MWD at 6 months after implantation.
Key Words
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Article info
Publication history
Published online: May 14, 2020
Accepted:
April 6,
2020
Received in revised form:
March 22,
2020
Received:
June 18,
2019
Identification
Copyright
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