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Abbreviations CRP: C-reactive protein eGFR: Estimated glomerular filtration rate ESHF: End-stage heart failure HF: Heart failure IL-: Interleukin INTERMACS: Interagency Registry for Mechanically Assisted Circulatory Support LVEF: Left ventricular ejection fraction MCS: Mechanical circulatory support MOFS: Severe multiorgan failure syndrome sICAM-1: Soluble intercellular adhesion molecule type 1 sP-selectin: Soluble platelet selectin TNF: Tumor necrosis factor tSOFA: Total sequential organ failure assessment score.
Inflammatory Condition of ESHF Patients at Baseline.
Plasma levels of novel and traditional inflammatory mediators were measured in ESHF patients (pre-LVAD group) before and one month after LVAD implant (Figure 2).
The clinical course of ESHF patients (pre-LVAD group) was evaluated considering the outcome indices.
The present study shows for the first time in a human model of HF that patients with ESHF presented differentially expressed levels of ST2/IL-33 as well as conventional inflammatory mediators, in both plasma and cardiac tissue, and that these modifications are corrected by mechanical unloading through LVAD support.
In this study, lower tissue expression of ST2 and IL-33 was found in cardiac tissue of patients undergoing LVAD support compared to more stable patients undergoing heart transplantation on medical therapy only, indicating that their decrease could be involved in the worsening of cardiac function in these groups of ESHF patients [1-6].
In fact, ESHF related to myocardial infarction has been shown to have much poorer response to LVAD therapy than nonischemic IDC [28].