Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3
Left ventricular assist device (LVAD) implantation is one of the mechanical circulatory support (MCS) treatments for advanced heart failure (HF) patients. MCS has emerged as a lifesaving therapy that improves patients’ quality of life. However, MCS remains limited by a paradoxical coagulopathy accom...
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| author | Madina R. Zhalbinova Saule E. Rakhimova Ulan A. Kozhamkulov Gulbanu A. Akilzhanova Assel A. Chinybayeva Kenes R. Akilzhanov Nurlan K. Shaimardanov Anargul G. Kuanysheva Joseph H. Lee Ulykbek Y. Kairov Makhabbat S. Bekbossynova Ainur R. Akilzhanova |
| author_facet | Madina R. Zhalbinova Saule E. Rakhimova Ulan A. Kozhamkulov Gulbanu A. Akilzhanova Assel A. Chinybayeva Kenes R. Akilzhanov Nurlan K. Shaimardanov Anargul G. Kuanysheva Joseph H. Lee Ulykbek Y. Kairov Makhabbat S. Bekbossynova Ainur R. Akilzhanova |
| author_sort | Madina R. Zhalbinova |
| collection | DOAJ |
| description | Left ventricular assist device (LVAD) implantation is one of the mechanical circulatory support (MCS) treatments for advanced heart failure (HF) patients. MCS has emerged as a lifesaving therapy that improves patients’ quality of life. However, MCS remains limited by a paradoxical coagulopathy accompanied by thrombosis and bleeding. The mechanisms of MCS thrombosis are increasingly being defined, but MCS-related bleeding, which is related to shear-mediated alteration of platelet function, remains poorly understood. Complications might develop due to the high non-physiological shear stress in the device and as a consequence of individual variability in response to the antithrombotic therapy. Thromboelastography (TEG) and genotyping of gene polymorphisms that are involved in the coagulation cascade and in the metabolism of the antithrombotic therapy might be valuable sources of information for the reduction of complication development. The aim of the study was to identify genetic factors related to the development of device complications according to the implanted LVAD type. We compared the clinical and genetic data of HF patients (<i>n</i> = 98) with/without complications with three types of implanted devices: HeartWare HVAD (HW), HeartMate II (HMII), and HeartMate 3 (HM3). rs9923231 in <i>VKORC1</i> (95%CI −6.28–0.22, <i>p</i> = 0.04) and rs5918 in <i>ITGB3</i> genes (95%CI 0.003–4.36, <i>p</i> = 0.05) showed significant association with the TEG coagulation index parameter, which identified hyper- and hypo-coagulation states. The wild genotype of rs5918 in the <i>ITGB3</i> gene prevailed in patients implanted with HM3 devices, which developed fewer complications than with HMII (<i>p</i> = 0.04). Individual genetic information could be useful in the management of patients with HF and the implantation of MCS to reduce the development of complications. |
| first_indexed | 2024-03-09T01:49:01Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:49:01Z |
| publishDate | 2023-11-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-88c8aab66f4e4893ae37e6e1391c114e2023-12-08T15:18:46ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223723510.3390/jcm12237235Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3Madina R. Zhalbinova0Saule E. Rakhimova1Ulan A. Kozhamkulov2Gulbanu A. Akilzhanova3Assel A. Chinybayeva4Kenes R. Akilzhanov5Nurlan K. Shaimardanov6Anargul G. Kuanysheva7Joseph H. Lee8Ulykbek Y. Kairov9Makhabbat S. Bekbossynova10Ainur R. Akilzhanova11National Laboratory Astana, Nazarbayev University, Astana 010000, KazakhstanNational Laboratory Astana, Nazarbayev University, Astana 010000, KazakhstanNational Laboratory Astana, Nazarbayev University, Astana 010000, KazakhstanDepartment of Medicine, Semey Medical University, Pavlodar Branch, Pavlodar 140000, KazakhstanRepublic Diagnostic Center, CF “University Medical Center”, Astana 010000, KazakhstanDepartment of Medicine, Semey Medical University, Pavlodar Branch, Pavlodar 140000, KazakhstanDepartment of Medicine, Semey Medical University, Semey 071400, KazakhstanDepartment of Medicine, Semey Medical University, Semey 071400, KazakhstanSergievsky Center, Taub Institute, Columbia University Medical Center, New York, NY 10032, USANational Laboratory Astana, Nazarbayev University, Astana 010000, KazakhstanNational Research Cardiac Surgery Center, Astana 010000, KazakhstanNational Laboratory Astana, Nazarbayev University, Astana 010000, KazakhstanLeft ventricular assist device (LVAD) implantation is one of the mechanical circulatory support (MCS) treatments for advanced heart failure (HF) patients. MCS has emerged as a lifesaving therapy that improves patients’ quality of life. However, MCS remains limited by a paradoxical coagulopathy accompanied by thrombosis and bleeding. The mechanisms of MCS thrombosis are increasingly being defined, but MCS-related bleeding, which is related to shear-mediated alteration of platelet function, remains poorly understood. Complications might develop due to the high non-physiological shear stress in the device and as a consequence of individual variability in response to the antithrombotic therapy. Thromboelastography (TEG) and genotyping of gene polymorphisms that are involved in the coagulation cascade and in the metabolism of the antithrombotic therapy might be valuable sources of information for the reduction of complication development. The aim of the study was to identify genetic factors related to the development of device complications according to the implanted LVAD type. We compared the clinical and genetic data of HF patients (<i>n</i> = 98) with/without complications with three types of implanted devices: HeartWare HVAD (HW), HeartMate II (HMII), and HeartMate 3 (HM3). rs9923231 in <i>VKORC1</i> (95%CI −6.28–0.22, <i>p</i> = 0.04) and rs5918 in <i>ITGB3</i> genes (95%CI 0.003–4.36, <i>p</i> = 0.05) showed significant association with the TEG coagulation index parameter, which identified hyper- and hypo-coagulation states. The wild genotype of rs5918 in the <i>ITGB3</i> gene prevailed in patients implanted with HM3 devices, which developed fewer complications than with HMII (<i>p</i> = 0.04). Individual genetic information could be useful in the management of patients with HF and the implantation of MCS to reduce the development of complications.https://www.mdpi.com/2077-0383/12/23/7235genotypepolymorphismheart failureleft ventricular assist device (LVAD)mechanical circulatory support (MCS) |
| spellingShingle | Madina R. Zhalbinova Saule E. Rakhimova Ulan A. Kozhamkulov Gulbanu A. Akilzhanova Assel A. Chinybayeva Kenes R. Akilzhanov Nurlan K. Shaimardanov Anargul G. Kuanysheva Joseph H. Lee Ulykbek Y. Kairov Makhabbat S. Bekbossynova Ainur R. Akilzhanova Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3 Journal of Clinical Medicine genotype polymorphism heart failure left ventricular assist device (LVAD) mechanical circulatory support (MCS) |
| title | Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3 |
| title_full | Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3 |
| title_fullStr | Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3 |
| title_full_unstemmed | Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3 |
| title_short | Role of Genetic Polymorphisms in the Development of Complications in Patients with Implanted Left Ventricular Assist Devices: HeartWare, HeartMate II, and HeartMate 3 |
| title_sort | role of genetic polymorphisms in the development of complications in patients with implanted left ventricular assist devices heartware heartmate ii and heartmate 3 |
| topic | genotype polymorphism heart failure left ventricular assist device (LVAD) mechanical circulatory support (MCS) |
| url | https://www.mdpi.com/2077-0383/12/23/7235 |
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