Imamura Teruhiko, Combs Pamela, Siddiqi Umar, Cohen William, Besser Stephanie, LaBuhn Colleen, Mirzai Saeid, Jeevanandam Valluvan
Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
Second Department of Medicine, University of Toyama, Toyama, Japan.
Int J Artif Organs. 2021 Mar;44(3):188-193. doi: 10.1177/0391398820951810. Epub 2020 Sep 10.
The seasonal variation of incidence and severity of heart failure is well known. However, the impact of seasonal variation on clinical outcomes following left ventricular assist device (LVAD) implantation remains unknown.
We retrospectively reviewed consecutive patients who received LVAD implantation between January 2014 and December 2016 along with their first year of post-implant outcomes. Clinical outcomes were compared between those with winter LVAD implantation (between October and March) and those with non-winter LVAD implantation.
168 patients with a median age of 57 years and 130 males were included. There was no seasonal difference in the number of LVAD implantations. One-year survival free from major adverse events was significantly lower in the winter implant group ( = 88) compared to the non-winter group ( = 80) (44% vs 61%) with an adjusted hazard ratio of 1.81 (95% confidence interval 1.11-2.90, = 0.014), largely due to a higher rate of heart failure readmission in the winter implant patients (incidence rate ratio 2.29, 95% confidence interval 0.89-5.84).
Patients who underwent LVAD implantation during the winter season had a higher heart failure readmission rate. A detailed mechanism and therapeutic strategy given our findings warrant further investigation.
心力衰竭发病率和严重程度的季节性变化众所周知。然而，季节性变化对左心室辅助装置（LVAD）植入术后临床结局的影响仍不清楚。
我们回顾性分析了2014年1月至2016年12月期间连续接受LVAD植入的患者及其植入后第一年的结局。比较冬季（10月至3月）植入LVAD的患者与非冬季植入LVAD的患者的临床结局。
纳入168例患者，中位年龄57岁，男性130例。LVAD植入数量无季节性差异。冬季植入组（n = 88）1年无重大不良事件生存率显著低于非冬季组（n = 80）（44%对61%），调整后风险比为1.81（95%置信区间1.11 - 2.90，P = 0.014），主要原因是冬季植入患者心力衰竭再入院率较高（发病率比2.29，95%置信区间0.89 - 5.84）。
冬季接受LVAD植入的患者心力衰竭再入院率较高。鉴于我们的研究结果，详细的机制和治疗策略值得进一步研究。
