{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:39:46Z","timestamp":1753889986838,"version":"3.41.2"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Metabolic impairment is common in heart failure patients. Continuous\u2010flow left ventricular assist devices (\n              <jats:styled-content style=\"fixed-case\">CF<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">LVADs<\/jats:styled-content>\n              ) improve hemodynamics and outcomes in patients with advanced heart failure; however, the effect of\n              <jats:styled-content style=\"fixed-case\">CF<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">LVADs<\/jats:styled-content>\n              on metabolic status is unknown. This study aims to evaluate the changes in metabolic status following\n              <jats:styled-content style=\"fixed-case\">CF<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content>\n              implantation and measure the correlation of metabolic status with outcomes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Prospective data on\n              <jats:styled-content style=\"fixed-case\">CF<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content>\n              patients were obtained. Metabolic evaluation, including hemoglobin A1C, free and total testosterone, thyroid\u2010stimulating hormone (\n              <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>\n              ), and free T4, was obtained before and at multiple time points following implantation. Patients with nonelevated thyroid\u2010stimulating hormone and normal hemoglobin A1C and testosterone levels were defined as having normal metabolic status. Baseline characteristics, hemodynamics, and outcomes were collected. One hundred six patients were studied, of which 56 had paired data at baseline and 1\u2010 to 3\u2010month follow\u2010up. Before implantation, 75% of patients had insulin resistance, 86% of men and 39% of women had low free testosterone, and 44% of patients had abnormal thyroid function. There was a significant improvement in hemoglobin A1C, free testosterone, and thyroid\u2010stimulating hormone following implantation (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001 for all). Patients with normal hemoglobin A1C (&lt;5.7%) following implantation had higher 1\u2010year survival free of heart failure readmissions (78% versus 23%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Patients with normal metabolic status following implantation also had higher 1\u2010year survival free of heart failure readmissions (92% versus 54%;\n              <jats:italic>P<\/jats:italic>\n              =0.04).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Metabolic dysfunction is highly prevalent in advanced heart failure patients and improves after\n              <jats:styled-content style=\"fixed-case\">CF<\/jats:styled-content>\n              \u2010\n              <jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content>\n              implantation. Normal metabolic status is associated with a significantly higher rate of 1\u2010year survival free of heart failure readmissions.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013278","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T10:00:27Z","timestamp":1573639227000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Metabolic Dysfunction in Continuous\u2010Flow Left Ventricular Assist Devices Patients and Outcomes"],"prefix":"10.1161","volume":"8","author":[{"given":"Ann B.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teruhiko","family":"Imamura","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Besser","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Chung","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayant","family":"Raikhelkar","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Kalantari","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Smith","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitasha","family":"Sarswat","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen","family":"LaBuhn","sequence":"additional","affiliation":[{"name":"Section of Cardiac Surgery Department of Surgery University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valluvan","family":"Jeevanandam","sequence":"additional","affiliation":[{"name":"Section of Cardiac Surgery Department of Surgery University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gene","family":"Kim","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Sayer","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Uriel","sequence":"additional","affiliation":[{"name":"Section of Cardiology Department of Medicine University of Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.053"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000350"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31829e8776"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.083"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11897-016-0289-5"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardiores.2006.08.018"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0b013e3283469505"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.2.526"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.07.005"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.2307\/3001968"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780040112"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","article-title":"Regression models and life\u2010tables","volume":"34","author":"Cox DR","year":"1972","unstructured":"Cox DR. 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