Preimplant Hyponatremia Does Not Predict Adverse Outcomes in Patients With Left Ventricular Assist Devices

Antonio Duran; Austin Tutor; Farnoosh Shariati; Amber Sleem; James Wever-Pinzon; Sapna Desai; Clement Eiswirth; Hector O Ventura; Selim R Krim

doi:10.1016/j.cpcardiol.2022.101239

Preimplant Hyponatremia Does Not Predict Adverse Outcomes in Patients With Left Ventricular Assist Devices

Curr Probl Cardiol. 2023 Aug;48(8):101239. doi: 10.1016/j.cpcardiol.2022.101239. Epub 2022 May 2.

Authors

Antonio Duran¹, Austin Tutor², Farnoosh Shariati², Amber Sleem², James Wever-Pinzon³, Sapna Desai³, Clement Eiswirth³, Hector O Ventura⁴, Selim R Krim⁴

Affiliations

¹ Division of Cardiology, John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, LA; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA. Electronic address: antonio.duran@ochsner.org.
² Department of Internal Medicine, Ochsner Medical Center, New Orleans, LA.
³ Division of Cardiology, John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, LA; Section of Cardiomyopathy & Heart Transplantation, John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, LA.
⁴ Division of Cardiology, John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, LA; Section of Cardiomyopathy & Heart Transplantation, John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, LA; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.

PMID: 35513184
DOI: 10.1016/j.cpcardiol.2022.101239

Abstract

Hyponatremia is a well-established marker of adverse outcomes in chronic heart failure (HF) but not well studied in patients with left ventricular assist device (LVAD). This is a retrospective study, single center study of HM3 [Abbott, USA] LVAD implants. We divided our population based on their sodium prior to LVAD implantation - hyponatremia if <135 mEq/L and normal sodium if 135-145 mEq/L. We compared postoperative and long-term outcomes. A total of 195 patients were included, preimplant hyponatremia was present in 40% with a sodium of 132.1 ± 2.1 vs 137.8 ± 1.9 mEq/L in the normal sodium group. No differences were observed in the postoperative or long-term outcomes. Preimplant hyponatremia was not associated with mortality or HF admissions, likely due to adequate left ventricular unloading and resolution of the mechanisms that lead to hyponatremia. These results suggest that optimization of mild hyponatremia may not be critical and should not delay LVAD placement.

Publication types

Review

MeSH terms

Heart Failure* / epidemiology
Heart-Assist Devices* / adverse effects
Humans
Hyponatremia* / complications
Hyponatremia* / etiology
Retrospective Studies
Sodium
Treatment Outcome

Substances

Sodium