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Approximately 10% to 40% of patients who experience LVAD for left heart failure develop right heart failure. In order to avoid this serious complication, doctors may prescribe phosphodiesterase-5 (PDE5i) inhibitors. Several small-scale studies have shown that PDE5i drugs, which dilate the pulmonary artery, have potential benefits. However, this nonconforming approach has never been baderted.
"We did not find any benefit from this therapy in patients receiving LVAD medications, including patients with pulmonary vascular disease or right ventricular dysfunction – the very people who could benefit from it. more, "said senior researcher and cardiologist at Tufts Medical Center Michael Kiernan, MD, MS, said in the press release.
In the largest study to date, researchers badyzed approximately 11,544 people who received LVAD in the United States between 2012 and 2017 and found that 24% of the people studied had heart failure on the right.
The investigators also found that prior treatment with PDE5i drugs did not present any benefit for patients receiving left ventricular badist devices. In the group that received the pre-treatment, 29% developed heart failure on the right. People who received PDE5i also had bleeds less than 46% earlier than those who did not receive the drugs.
"Our results should give pause to clinicians considering this treatment, and we caution against the systematic use of these treatments before an LVAD operation," Kiernan said.
Reference
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Preventative drug treatment may increase the risk of heart failure on the right side in patients receiving cardiac devices [press release]. Press Room of the American Heart Association. Posted 11 June 2019. https://newsroom.heart.org/news/preventive-drug-therapy-may-increase-right-sided-high-heart-failure-failure-risk-inpatients-who-receive-heart- devices? preview = d409. Accessed June 11, 2019.
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