Gastrointestinal angiodysplasia in heart failure and during CF LVAD support

J Heart Lung Transplant. 2022 Feb;41(2):129-132. doi: 10.1016/j.healun.2021.11.009. Epub 2021 Nov 14.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Colonoscopy / methods
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Tract / blood supply*
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • New York / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume / physiology*
  • Ventricular Function, Left / physiology*