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9. The safety of sodium glucose transporter 2 inhibitors and trends in clinical and hemodynamic parameters in patients with left ventricular assist devices.

Author

Fardman, Alexander, Kodesh, Afek, Siegel, Allison Joyce, Segev, Amitai, Regev, Ehud, Maor, Elad, Berkovitch, Anat, Kuperstein, Rafael, Morgan, Avi, Nahum, Eyal, Peled, Yael, and Grupper, Avishay

Subjects
HEART assist devices, GLUCOSE transporters, PULMONARY artery, CARDIAC catheterization, PATIENT safety, FUROSEMIDE, SODIUM-glucose cotransporters
Abstract

Background: The safety and impact of sodium glucose transporter 2 inhibitors (SGLT2‐I) in patients with left ventricular assist devices (LVAD) are unknown. Methods: A retrospective analysis of all consecutive patients who underwent LVAD Heart Mate 3 (HM3) implantation at a single medical center and received SGLT2‐I therapy following surgery was conducted. LVAD parameters, medical therapy, laboratory tests, echocardiography, and right heart catheterization (RHC) study results were recorded and compared before and after initiation of SGLT2‐I. Results: SGLT2‐I medications were initiated in 29 (21%) of 138 patients following HM3 implantation (23 (79%) received Empagliflozin and 6 (21%) Dapagliflozin). The mean age at the time of LVAD implantation was 62 ± 6.7 years, 25 (86%) were male, and 23 (79%) had diabetes mellitus. The median time from HM3 implantation to SGLT2‐I initiation was 108 days, IQR (26–477). Following SGLT2‐I therapy, the daily dose of furosemide decreased from 47 to 23.5 mg/day (mean difference = 23.5 mg/d, 95% CI 8.2–38.7, p = 0.004) and significant weight reduction was observed (mean difference 2.5 kg, 95% CI 0.7–4.3, p = 0.008). Moreover, a significant 5.6 mm Hg reduction in systolic pulmonary artery pressure (sPAP) was measured during RHC (95% CI 0.23–11, p = 0.042) in a subgroup of 11 (38%) patients. LVAD parameters were similar before and after SGLT2‐I initiation (p > 0.2 for all). No adverse events were recorded during median follow‐up of 354 days, IQR (206–786). Conclusion: SGLT2‐I treatment is safe in LVAD patients and might contribute to reduction in patients sPAP. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Clinical predictors of left ventricular thrombus after myocardial infarction as detected by magnetic resonance imaging

Author

Fardman, Alexander, primary, Massalha, Eias, additional, Natanzon, Sharon Shalom, additional, Brodov, Yafim, additional, Goitein, Orly, additional, Chernomordik, Fernando, additional, Herscovici, Romana, additional, Grupper, Avishay, additional, Kuperstein, Rafael, additional, Mazin, Israel, additional, Matetzky, Shlomi, additional, and Beigel, Roy, additional

Published
2024
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22. Surgical ablation for atrial fibrillation: impact of diabetes mellitus

Author

Kogan, Alexander, primary, Grupper, Avishay, additional, Sabbag, Avi, additional, Ram, Eilon, additional, Jamal, Tamer, additional, Nof, Eyal, additional, Fisman, Enrique (Zvi), additional, Levin, Shany, additional, Beinart, Roy, additional, Frogel, Jonathan, additional, Raanani, Ehud, additional, and Sternik, Leonid, additional

Published
2023
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32. Hemodynamic Changes After Left Ventricular Assist Device Implantation Among Heart Failure Patients With and Without Elevated Pulmonary Vascular Resistance

Author

Grupper, Avishay, primary, Mazin, Israel, additional, Faierstein, Kobi, additional, Kurnick, Adam, additional, Maor, Elad, additional, Elian, Dan, additional, Barbash, Israel M., additional, Guetta, Victor, additional, Regev, Ehud, additional, Morgan, Avi, additional, Segev, Amit, additional, Lavee, Jacob, additional, and Fefer, Paul, additional

Published
2022
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38. HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1: Introduction and at the non-hospital settings in the community

Author

Ben Avraham, Binyamin, Crespo-Leiro, Marisa Generosa, Filippatos, Gerasimos, Gotsman, Israel, Seferovic, Petar, Hasin, Tal, Potena, Luciano, Milicic, Davor, Coats, Andrew J S, Rosano, Giuseppe, Ruschitzka, Frank, Metra, Marco, Anker, Stefan, Altenberger, Johann, Adamopoulos, Stamatis, Barac, Yaron D, Chioncel, Ovidiu, De Jonge, Nicolaas, Elliston, Jeremy, Frigeiro, Maria, Goncalvesova, Eva, Grupper, Avishay, Hamdan, Righab, Hammer, Yoav, Hill, Loreena, Itzhaki Ben Zadok, Osnat, Abuhazira, Miriam, Lavee, Jacob, Mullens, Wilfried, Nalbantgil, Sanemn, et al, and University of Zurich

Subjects
10209 Clinic for Cardiology, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine
Published
2021

41. Navigating between Scylla and Charybdis: challenges and strategies for implementing guideline‐directed medical therapy in heart failure with reduced ejection fraction

Author

Seferović, Petar M., primary, Polovina, Marija, additional, Adlbrecht, Christopher, additional, Bělohlávek, Jan, additional, Chioncel, Ovidiu, additional, Goncalvesová, Eva, additional, Milinković, Ivan, additional, Grupper, Avishay, additional, Halmosi, Róbert, additional, Kamzola, Ginta, additional, Koskinas, Konstantinos C., additional, Lopatin, Yuri, additional, Parkhomenko, Alexander, additional, Põder, Pentti, additional, Ristić, Arsen D., additional, Šakalytė, Gintarė, additional, Trbušić, Matias, additional, Tundybayeva, Meiramgul, additional, Vrtovec, Bojan, additional, Yotov, Yoto T., additional, Miličić, Davor, additional, Ponikowski, Piotr, additional, Metra, Marco, additional, Rosano, Giuseppe, additional, and Coats, Andrew J.S., additional

Published
2021
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42. HeartMate 3: new challenges in ventricular tachycardia ablation

Author

Nof, Eyal, primary, Peichl, Petr, additional, Stojadinovic, Predrag, additional, Arceluz, Martin, additional, Maury, Philippe, additional, Katz, Moshe, additional, Tedrow, Usha B, additional, Singh, Robin M, additional, Narui, Ryohsuke, additional, John, Roy M, additional, Stevenson, William G, additional, Beinart, Roy, additional, Grupper, Avishay, additional, Sternik, Leonid, additional, Lavee, Jacob, additional, Sacher, Frédéric, additional, Kautzner, Josef, additional, and Sabbag, Avi, additional

Published
2021
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44. HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1: Introduction and at the non‐hospital settings in the community

Author

Ben Avraham, Binyamin, primary, Crespo‐Leiro, Marisa Generosa, additional, Filippatos, Gerasimos, additional, Gotsman, Israel, additional, Seferovic, Petar, additional, Hasin, Tal, additional, Potena, Luciano, additional, Milicic, Davor, additional, Coats, Andrew J.S., additional, Rosano, Giuseppe, additional, Ruschitzka, Frank, additional, Metra, Marco, additional, Anker, Stefan, additional, Altenberger, Johann, additional, Adamopoulos, Stamatis, additional, Barac, Yaron D., additional, Chioncel, Ovidiu, additional, De Jonge, Nicolaas, additional, Elliston, Jeremy, additional, Frigeiro, Maria, additional, Goncalvesova, Eva, additional, Grupper, Avishay, additional, Hamdan, Righab, additional, Hammer, Yoav, additional, Hill, Loreena, additional, Itzhaki Ben Zadok, Osnat, additional, Abuhazira, Miriam, additional, Lavee, Jacob, additional, Mullens, Wilfried, additional, Nalbantgil, Sanemn, additional, Piepoli, Massimo F., additional, Ponikowski, Piotr, additional, Ristic, Arsen, additional, Ruhparwar, Arjang, additional, Shaul, Aviv, additional, Tops, Laurens F., additional, Tsui, Steven, additional, Winnik, Stephan, additional, Jaarsma, Tiny, additional, Gustafsson, Finn, additional, and Ben Gal, Tuvia, additional

Published
2021
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48. HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1:Introduction and at the non-hospital settings in the community

Author

Ben Avraham, Binyamin, Crespo-Leiro, Marisa Generosa, Filippatos, Gerasimos, Gotsman, Israel, Seferovic, Petar, Hasin, Tal, Potena, Luciano, Milicic, Davor, Coats, Andrew J. S., Rosano, Giuseppe, Ruschitzka, Frank, Metra, Marco, Anker, Stefan, Altenberger, Johann, Adamopoulos, Stamatis, Barac, Yaron D., Chioncel, Ovidiu, De Jonge, Nicolaas, Elliston, Jeremy, Frigeiro, Maria, Goncalvesova, Eva, Grupper, Avishay, Hamdan, Righab, Hammer, Yoav, Hill, Loreena, Itzhaki Ben Zadok, Osnat, Abuhazira, Miriam, Lavee, Jacob, Mullens, Wilfried, Nalbantgil, Sanemn, Piepoli, Massimo F, Ponikowski, Piotr, Ristic, Arsen, Ruhparwar, Arjang, Shaul, Aviv, Tops, Laurens F., Tsui, Steven, Winnik, Stephan, Jaarsma, Tiny, Gustafsson, Finn, Ben Gal, Tuvia, Ben Avraham, Binyamin, Crespo-Leiro, Marisa Generosa, Filippatos, Gerasimos, Gotsman, Israel, Seferovic, Petar, Hasin, Tal, Potena, Luciano, Milicic, Davor, Coats, Andrew J. S., Rosano, Giuseppe, Ruschitzka, Frank, Metra, Marco, Anker, Stefan, Altenberger, Johann, Adamopoulos, Stamatis, Barac, Yaron D., Chioncel, Ovidiu, De Jonge, Nicolaas, Elliston, Jeremy, Frigeiro, Maria, Goncalvesova, Eva, Grupper, Avishay, Hamdan, Righab, Hammer, Yoav, Hill, Loreena, Itzhaki Ben Zadok, Osnat, Abuhazira, Miriam, Lavee, Jacob, Mullens, Wilfried, Nalbantgil, Sanemn, Piepoli, Massimo F, Ponikowski, Piotr, Ristic, Arsen, Ruhparwar, Arjang, Shaul, Aviv, Tops, Laurens F., Tsui, Steven, Winnik, Stephan, Jaarsma, Tiny, Gustafsson, Finn, and Ben Gal, Tuvia

Abstract

The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of the LVAD-supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD-supported patients. The expected and non-expected device-related and patient–device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD-supported patients, mainly those supported with the ‘destination therapy’ indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD-supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non-LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non-LVAD specialized physician: ambulance clinicians, emergency ward physicians, general cardiologists, internists, anaesthesiologists, and surgeons, to comply with the medical needs of this fast-growing population of LVAD-supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department and from the emergency department to the internal or surgical wards and eventually to the discharge home from the hospital back to the general practitioner. In this first part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, after the introduction on the assist devices technology in general, definitions and structured approach to the assessment of the LVAD-supported patient in the ambulance and emergency department is presented including cardiopulmonary resuscitation for LVAD-supported patients.

Published
2021

50. impact of diabetes on short-, intermediate- and long-term mortality following left ventricular assist device implantation.

Author

Kogan, Alexander, Frogel, Jonathan, Ram, Eilon, Jamal, Tamer, Peled-Potashnik, Yael, Maor, Elad, Grupper, Avishay, Morgan, Avi, Segev, Amit, Raanani, Ehud, and Sternik, Leonid

Subjects
HEART assist devices, TYPE 2 diabetes, MORTALITY
Abstract

Open in new tab Download slide Open in new tab Download slide OBJECTIVES Type 2 diabetes mellitus (DM) is a frequent comorbidity among patients suffering from advanced heart failure necessitating a left ventricular assist device (LVAD) implant. The goal of this study was to evaluate the impact of type 2 DM on early and long-term outcomes of patients following an LVAD implant. METHODS We performed an observational cohort study in a large tertiary care centre in Israel. All data of patients who underwent a continuous flow LVAD implant between 2006 and 2020 were extracted from our departmental database. Patients were divided into 2 groups: group I (patients without diabetes) and group II (patients with diabetes). We compared short-term (30-day and 3-month) mortality, intermediate-term (1- and 3-year) mortality and long-term (5 year) mortality between the 2 groups. RESULTS The study population included 154 patients. Group I (patients without diabetes) comprised 88 patients and group II (patients with diabetes) comprised 66 patients. The mean follow-up duration was 38.2 ± 30.3 months. Short- and intermediate-term mortality (30 days, 1 year and 3 years) was higher in the group with DM compared with the group without DM but did not reach any statistically significant difference: 16.1% vs 9.8% (P  =   0.312), 24.2% vs 17.3% (P  = 0.399) and 30.6% vs 21.9% (P  = 0.127) respectively. Long-term 5-year mortality was significantly higher in the group with DM compared to the group without: 38.7% vs 24.4% (P  = 0.038). Furthermore, predictors of long-term mortality included diabetes (hazard ratio 2.09, confidence interval 1.34–2.84, P  = 0.004), as demonstrated by regression analysis. CONCLUSIONS Patients with diabetes and those without diabetes have similar 30-day and short- and intermediate-term mortality rates. The mortality risk of diabetic patients begins to increase 3 years after an LVAD implant. Diabetes is an independent predictor of long-term, 5-year mortality after an LVAD implant. Clinical trial registration Ethical Committee of Sheba Medical Centre, Israel, on 2 December 2014, Protocol 4257. [ABSTRACT FROM AUTHOR]

Published
2022
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