Gastrointestinal angiodysplasia in heart failure and during CF LVAD support

Snehal R. Patel; Sasha Vukelic; Thiru Chinnadurai; Shivank Madan; Nicholas Sibinga; Joann Kwah; Omar Saeed; Daniel J. Goldstein; Ulrich P. Jorde

doi:10.1016/j.healun.2021.11.009

Gastrointestinal angiodysplasia in heart failure and during CF LVAD support

Snehal R. Patel, Sasha Vukelic, Thiru Chinnadurai, Shivank Madan, Nicholas Sibinga, Joann Kwah, Omar Saeed, Daniel J. Goldstein, Ulrich P. Jorde

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Angiodysplasias (AGD) are common sites of bleeding in the gastrointestinal (GI) tract after Continuous Flow Left Ventricular Assist Device (CF-LVAD) implantation. We sought to investigate whether AGDs are formed as a result of LVAD physiology or preexist as a consequence of heart failure. Thirty-six subjects with HF reduced EF (HFrEF) underwent video capsule endoscopy (VCE) to assess for the presence of AGD. Fifty-three subjects without HF who underwent VCE for a nonbleeding indication formed a control group. The prevalence of AGD was significantly higher in the HFrEF compared to the non-HF controls (50% vs 13%, p = 0.0002). This association persisted after controlling for age and comorbidities. Within the HFrEF cohort, higher Ang2, NT-proBNP and BUN were associated with the presence of AGD. AGD in the GI tract are associated with HFrEF. This is the first description of a new pathology associated with HFrEF and adds to our understanding of CF LVAD associated GI bleeding.

Original language	English (US)
Pages (from-to)	129-132
Number of pages	4
Journal	Journal of Heart and Lung Transplantation
Volume	41
Issue number	2
DOIs	https://doi.org/10.1016/j.healun.2021.11.009
State	Published - Feb 2022

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine
Transplantation

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10.1016/j.healun.2021.11.009

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title = "Gastrointestinal angiodysplasia in heart failure and during CF LVAD support",

abstract = "Angiodysplasias (AGD) are common sites of bleeding in the gastrointestinal (GI) tract after Continuous Flow Left Ventricular Assist Device (CF-LVAD) implantation. We sought to investigate whether AGDs are formed as a result of LVAD physiology or preexist as a consequence of heart failure. Thirty-six subjects with HF reduced EF (HFrEF) underwent video capsule endoscopy (VCE) to assess for the presence of AGD. Fifty-three subjects without HF who underwent VCE for a nonbleeding indication formed a control group. The prevalence of AGD was significantly higher in the HFrEF compared to the non-HF controls (50% vs 13%, p = 0.0002). This association persisted after controlling for age and comorbidities. Within the HFrEF cohort, higher Ang2, NT-proBNP and BUN were associated with the presence of AGD. AGD in the GI tract are associated with HFrEF. This is the first description of a new pathology associated with HFrEF and adds to our understanding of CF LVAD associated GI bleeding.",

author = "Patel, {Snehal R.} and Sasha Vukelic and Thiru Chinnadurai and Shivank Madan and Nicholas Sibinga and Joann Kwah and Omar Saeed and Goldstein, {Daniel J.} and Jorde, {Ulrich P.}",

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AU - Vukelic, Sasha

AU - Chinnadurai, Thiru

AU - Madan, Shivank

AU - Sibinga, Nicholas

AU - Kwah, Joann

AU - Saeed, Omar

AU - Goldstein, Daniel J.

AU - Jorde, Ulrich P.

PY - 2022/2

Y1 - 2022/2

N2 - Angiodysplasias (AGD) are common sites of bleeding in the gastrointestinal (GI) tract after Continuous Flow Left Ventricular Assist Device (CF-LVAD) implantation. We sought to investigate whether AGDs are formed as a result of LVAD physiology or preexist as a consequence of heart failure. Thirty-six subjects with HF reduced EF (HFrEF) underwent video capsule endoscopy (VCE) to assess for the presence of AGD. Fifty-three subjects without HF who underwent VCE for a nonbleeding indication formed a control group. The prevalence of AGD was significantly higher in the HFrEF compared to the non-HF controls (50% vs 13%, p = 0.0002). This association persisted after controlling for age and comorbidities. Within the HFrEF cohort, higher Ang2, NT-proBNP and BUN were associated with the presence of AGD. AGD in the GI tract are associated with HFrEF. This is the first description of a new pathology associated with HFrEF and adds to our understanding of CF LVAD associated GI bleeding.

AB - Angiodysplasias (AGD) are common sites of bleeding in the gastrointestinal (GI) tract after Continuous Flow Left Ventricular Assist Device (CF-LVAD) implantation. We sought to investigate whether AGDs are formed as a result of LVAD physiology or preexist as a consequence of heart failure. Thirty-six subjects with HF reduced EF (HFrEF) underwent video capsule endoscopy (VCE) to assess for the presence of AGD. Fifty-three subjects without HF who underwent VCE for a nonbleeding indication formed a control group. The prevalence of AGD was significantly higher in the HFrEF compared to the non-HF controls (50% vs 13%, p = 0.0002). This association persisted after controlling for age and comorbidities. Within the HFrEF cohort, higher Ang2, NT-proBNP and BUN were associated with the presence of AGD. AGD in the GI tract are associated with HFrEF. This is the first description of a new pathology associated with HFrEF and adds to our understanding of CF LVAD associated GI bleeding.

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Gastrointestinal angiodysplasia in heart failure and during CF LVAD support

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