From the INTEGRIS Advanced Cardiac Care, Nazih Zuhdi Transplant Institute, INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma.
Department of Bioengineering, University of Texas at Dallas, Richardson, TX.
ASAIO J. 2022 Aug 1;68(8):1036-1043. doi: 10.1097/MAT.0000000000001608. Epub 2021 Nov 10.
Infection is a serious adverse event limiting left ventricular assist device (LVAD) therapy in advanced heart failure patients, but a reliable means to identify patients at increased risk of infection is still lacking. We hypothesized that preoperative elevated levels of plasma Oncostatin M (OSM), a cytokine marker of leukocyte activation and inflammation, would be predictive of subsequent infection. We measured plasma OSM in 41 LVAD patients one day before LVAD implantation and postoperatively over two months. Preoperative plasma OSM levels were normal in 27 patients (group A, 4.9 ± 3.2 pg/ml) but elevated in 14 patients (group B, 1649.0 ± 458.9 pg/ml) ( p = 0.003). Early postoperative levels rose in both groups and declined rapidly in group A, with group B declining slowly over two months. Significantly more infections developed in group B than group A patients over two months postimplantation ( p = 0.004). No other routine clinical assessment or laboratory testing afforded this differentiation. These findings suggest that preoperative plasma OSM levels may assist in identifying patients at increased risk of infections after LVAD implantation.
感染是限制晚期心力衰竭患者左心室辅助装置(LVAD)治疗的严重不良事件,但仍缺乏可靠的方法来识别感染风险增加的患者。我们假设术前血浆中白细胞激活和炎症的细胞因子标志物 Oncostatin M(OSM)水平升高与随后的感染相关。我们在 LVAD 植入前一天和术后两个月内测量了 41 名 LVAD 患者的血浆 OSM。27 名患者(A 组,4.9±3.2pg/ml)术前血浆 OSM 水平正常,14 名患者(B 组,1649.0±458.9pg/ml)升高(p=0.003)。两组患者术后早期水平均升高,A 组迅速下降,B 组在两个月内缓慢下降。术后两个月,B 组比 A 组患者发生感染的明显更多(p=0.004)。其他常规临床评估或实验室检查均无法区分。这些发现表明术前血浆 OSM 水平可能有助于识别 LVAD 植入后感染风险增加的患者。