ASAIO Journal最新文献_第10页

Heart Transplantation Outcomes in Patients With Hypertrophic Cardiomyopathy in the Era of Mechanical Circulatory Support. 机械循环支持时代肥厚型心肌病患者的心脏移植结果。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2024-11-12 DOI: 10.1097/MAT.0000000000002347

Matylda Mazur, Robert Dowling, Geetha Bhat, Andres Carmona Rubio, Howard J Eisen

{"title":"Heart Transplantation Outcomes in Patients With Hypertrophic Cardiomyopathy in the Era of Mechanical Circulatory Support.","authors":"Matylda Mazur, Robert Dowling, Geetha Bhat, Andres Carmona Rubio, Howard J Eisen","doi":"10.1097/MAT.0000000000002347","DOIUrl":"10.1097/MAT.0000000000002347","url":null,"abstract":"Mechanical circulatory support has emerged as a vital therapeutic modality for patients awaiting heart transplantation (HT). However, it is unknown how it affected the characteristics and post-HT outcomes of patients with hypertrophic cardiomyopathy (HCM). This retrospective cohort study analyzed adult HT recipients from the International Society for Heart and Lung Transplantation registry (1998-2017). Two equal-duration eras were defined: era 1 1998-2007 and era 2 2008-2017. Patients with HCM were compared across the two eras (n 1 = 742 and n 2 = 1,211) and within each era, they were contrasted with individuals with nonischemic (NICM) (n 1 = 15,964 and n 2 = 20,394) and ischemic cardiomyopathy (ICM) (n 1 = 14,140 and n 2 = 12,986). Across eras, the number of HTs among patients with HCM increased by 63%. The rate of recipients with HCM in the intensive care unit (ICU) supported with intra-aortic balloon pump (IABP) increased, yet their pre-HT functional status improved, and 5 year post-HT survival remained unchanged and favorable. In era 2, at the time of HT, patients with HCM were more frequently than their NICM and ICM counterparts in the ICU and supported with inotropes. In the same era, 1 and 5 year survival were more favorable in HCM compared to ICM and comparable to NICM.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"409-417"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-Granularity Machine Learning Prediction of Acute Brain Injury in Patients Receiving Venoarterial Extracorporeal Membrane Oxygenation. 静脉体外膜氧合患者急性脑损伤的高粒度机器学习预测。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 DOI: 10.1097/MAT.0000000000002449

Mingfeng Cao, Shi Nan Feng, Yaman B Ahmed, Winnie Liu, Patricia Brown, Andrew Kalra, Benjamin Shou, Anastasios Bezerianos, Nitish Thakor, Glenn Whitman, Sung-Min Cho

{"title":"High-Granularity Machine Learning Prediction of Acute Brain Injury in Patients Receiving Venoarterial Extracorporeal Membrane Oxygenation.","authors":"Mingfeng Cao, Shi Nan Feng, Yaman B Ahmed, Winnie Liu, Patricia Brown, Andrew Kalra, Benjamin Shou, Anastasios Bezerianos, Nitish Thakor, Glenn Whitman, Sung-Min Cho","doi":"10.1097/MAT.0000000000002449","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002449","url":null,"abstract":"Acute brain injury (ABI) is prevalent among patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) and significantly impact recovery. Early prediction of ABI could enable timely interventions to prevent adverse outcomes, but existing predictive methods remain suboptimal. This study aimed to enhance ABI prediction using machine learning (ML) models and high-temporal-resolution granular data. We retrospectively analyzed 355 VA-ECMO patients treated at Johns Hopkins Hospital (JHH) from 2016 to 2024, collecting over 3 million data points from the JHH Research Electronic Data Capture (REDCap) database, with an average of 80,000 data points per patient. Acute brain injury was defined as ischemic stroke, intracranial hemorrhage, hypoxic-ischemic brain injury, or seizure. Four ML models were used: Random Forest, Categorical Boosting, Adaptive Boosting, and Extreme Gradient Boosting. Among 355 patients (median age 59 years, 56.9% male), 13.5% developed ABI. The models achieved an optimal area under the receiver operating characteristic curve (AUROC) of 0.79, accuracy of 87%, sensitivity of 53%, specificity of 99%, and precision-recall (PR)-AUC of 0.47. Key predictors included high minimum values of systolic blood pressure and variability in on-ECMO pulse pressure. High-resolution granular data enhanced ML performance for ABI prediction. Future efforts should focus on integrating continuous data platforms to enable real-time monitoring and personalized care, optimizing patient outcomes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Five-Year Outcomes in Patients Implanted With a HeartMate 3 Left Ventricular Assist Device at a High-Volume Center. 在一家高容量中心植入 HeartMate 3 左心室辅助装置的患者的五年疗效。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2024-09-26 DOI: 10.1097/MAT.0000000000002286

Giulio M Mondellini, Alice V Vinogradsky, Michael Kirschner, Alberto Pinsino, Annamaria Ladanyi, Paul A Kurlansky, Jocelyn Y Sun, Chunhui Wang, Jonathan M Hastie, Kevin J Clerkin, Yoshifumi Naka, Yuji Kaku, Gabriel T Sayer, Nir Uriel, Melana Yuzefpolskaya, Koji Takeda, Paolo C Colombo

引用次数: 0

Crossing-Borders: Experiences With International Transports on Extracorporeal Membrane Oxygenation: Special Considerations and Challenges. 跨国界：体外膜氧合的国际运输经验：特殊考虑和挑战。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2025-04-27 DOI: 10.1097/MAT.0000000000002349

Carmen Mesas Burgos, Björn Frenckner, Lars Mikael Broman

{"title":"Crossing-Borders: Experiences With International Transports on Extracorporeal Membrane Oxygenation: Special Considerations and Challenges.","authors":"Carmen Mesas Burgos, Björn Frenckner, Lars Mikael Broman","doi":"10.1097/MAT.0000000000002349","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002349","url":null,"abstract":"Extracorporeal membrane oxygenation (ECMO) is a crucial support for patients with severe cardiac or respiratory failure, but its availability is limited, often requiring patient transport to specialized centers. Only a few centers provide mobile ECMO services, and international ECMO transports are rare. This study reviews a department's experience with international ECMO transports from 1998 to 2022. Out of 1,277 ECMO transports, 357 (28%) were international. Most of these (52%) were directed to ECMO Center Karolinska, whereas others involved transfers due to a lack of beds or between foreign centers. The majority (79%) of patients were cannulated at the referring hospital, with 63% supported by venoarterial ECMO. Transport distances averaged 1,200 km, using fixed-wing aircraft 89% of the time. Hospital survival for those transported to Karolinska was 82%, and 36% of transports experienced complications, though no deaths occurred during transport. This study highlights the safety and effectiveness of international ECMO transport with highly trained teams.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":"71 5","pages":"418-425"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utilization and Outcomes of Temporary Percutaneous Right Ventricular Assist Devices in Cardiogenic Shock. 临时经皮右心室辅助装置在心源性休克中的应用和效果。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2024-11-13 DOI: 10.1097/MAT.0000000000002348

Kevin John John, Jaime Hernandez-Montfort, Manreet K Kanwar, Song Li, Arthur Reshad Garan, Shashank S Sinha, Jacob Abraham, Saraschandra Vallabhajosyula, Borui Li, Qiuyue Kong, Paavni Sangal, Daniel Burkhoff, Navin K Kapur

{"title":"Utilization and Outcomes of Temporary Percutaneous Right Ventricular Assist Devices in Cardiogenic Shock.","authors":"Kevin John John, Jaime Hernandez-Montfort, Manreet K Kanwar, Song Li, Arthur Reshad Garan, Shashank S Sinha, Jacob Abraham, Saraschandra Vallabhajosyula, Borui Li, Qiuyue Kong, Paavni Sangal, Daniel Burkhoff, Navin K Kapur","doi":"10.1097/MAT.0000000000002348","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002348","url":null,"abstract":"Acute right ventricular failure (RVF) is a common finding in cardiogenic shock (CS), yet the optimal method of supporting the failing RV remains unclear. This study aimed to describe CS patients receiving percutaneous right ventricular assist devices (pRVADs) using the multicenter Cardiogenic Shock Working Group (CSWG) registry. Among 6,201 patients with CS, 152 (2.4%) received pRVADs, with ProtekDuo and Impella RP being used in 71% and 29% of cases, respectively. The average age of this group was 58.5 years, with a higher proportion of men (66.4%). Heart failure-associated CS (HF-CS) was observed in 48% of patients, while myocardial infarction-associated CS (MI-CS) was seen in 27% (HF-CS versus MI-CS: 52.8% vs. 21.3% for ProtekDuo; 36.4% vs. 40.9% for Impella RP; p = 0.01). The overall in-hospital mortality rate was 54.6%, bleeding complications were more prevalent among ProtekDuo recipients (64.8% vs. 43.2%, p = 0.008), whereas Impella RP recipients had shorter hospital stays (20.4 ± 18.7 vs. 41.9 ± 31.5 days, p < 0.001). ProtekDuo was more commonly used in patients with HF-CS and was associated with higher rates of bleeding and longer hospital stays compared with Impella RP, although overall mortality was similar. Further investigation is required to determine the ideal timing and clinical conditions warranting pRVAD deployment in CS.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":"71 5","pages":"379-386"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional and Social Recovery and Outcomes After Extracorporeal Membrane Oxygenation Support in COVID-19 Patients. COVID-19 患者体外膜氧合支持术后的功能和社交能力恢复及疗效。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2024-10-15 DOI: 10.1097/MAT.0000000000002337

Mustafa Mert Ozgur, Ece Altinay, Halide Ogus, Rezzan Deniz Acar, Pinar Atagun Guney, Kaan Kirali

{"title":"Functional and Social Recovery and Outcomes After Extracorporeal Membrane Oxygenation Support in COVID-19 Patients.","authors":"Mustafa Mert Ozgur, Ece Altinay, Halide Ogus, Rezzan Deniz Acar, Pinar Atagun Guney, Kaan Kirali","doi":"10.1097/MAT.0000000000002337","DOIUrl":"10.1097/MAT.0000000000002337","url":null,"abstract":"With the COVID pandemic, veno-venous (VV) extracorporeal membrane oxygenation (ECMO) was implanted in many patients around the world. Data regarding follow-up and recovery of patients who are placed on ECMO support after COVID-related acute respiratory distress syndrome (ARDS) or ARDS for any other reason are limited. In our study, we share the 1 year follow-up results and cardiopulmonary exercise test results of the discharged patients. Between April 2020 and February 2022, a total of 29 patients who were supported with VV ECMO due to coronavirus disease 2019 (COVID-19)-related ARDS, weaned successfully and discharged to home, and who came for regular follow-up after discharge from the hospital and underwent examinations were included in the study. A total of 35 patients weaned successfully. Thirty patients were discharged to home. Mean age of the patients was 37.1 (±10.3) and 16 (55%) patients were male. Mean ECMO support time was 49.1 (±22.3) days. One year of survival after discharge was 100%. None of the patients had mobilization problems at the end of 12 month follow-up. Mean VO 2 max was 18.9 at the end of 12 months. Return to work rate was 90%. We think that starting rehabilitation in the early period, and including patients in post-ECMO follow-up programs by ECMO centers will contribute significantly not only to the functional recovery of patients but also to their integration into social life.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"396-402"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prosthetic Valve Fate in Patients With Continuous-Flow Left Ventricular Assist Devices. 持续流左心室辅助装置患者的人工瓣膜命运。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2024-11-12 DOI: 10.1097/MAT.0000000000002345

Daisuke Kaneyuki, Krushang Patel, Alice V Vinogradsky, Kavya Rajesh, Melissa A Hynds, Paul A Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Gabriel T Sayer, Nir Uriel, Yoshifumi Naka, Koji Takeda

{"title":"Prosthetic Valve Fate in Patients With Continuous-Flow Left Ventricular Assist Devices.","authors":"Daisuke Kaneyuki, Krushang Patel, Alice V Vinogradsky, Kavya Rajesh, Melissa A Hynds, Paul A Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Gabriel T Sayer, Nir Uriel, Yoshifumi Naka, Koji Takeda","doi":"10.1097/MAT.0000000000002345","DOIUrl":"10.1097/MAT.0000000000002345","url":null,"abstract":"Prosthetic valve-related morbidity and mortality in patients with left ventricular assist devices (LVADs) remain unclear. We retrospectively reviewed patients who received a HeartMate II or 3 LVAD at our center between April 2004 and December 2022. Patients with a valve prosthesis in any position were included. Of the 726 LVAD recipients, 74 (10.2%) underwent valve replacement before (n = 37, 50.0%), concomitantly with (n = 32, 43.2%), or after (n = 6, 8.1%) LVAD insertion. Prosthetic valves were implanted in the aortic (n = 32), mitral (n = 23), and tricuspid (n = 26) positions. Mechanical valves were present in eight (three aortic, five mitral) patients. At a median follow-up of 1.97 years post-VAD (interquartile range [IQR]: 0.56-4.58 years), there was one valve-related death due to severe aortic bioprosthetic insufficiency. Five of 28 (17.9%) patients with an aortic bioprosthesis had evidence of dysfunction on follow-up echocardiography. Median time to first sign of aortic bioprosthetic valve dysfunction was 1 (IQR: 0.6-5.1) year from time of LVAD with the prosthesis in place and 10.8 (IQR: 9.5-12.6) years from date of initial valve insertion. Prosthetic valve-related mortality or reinterventions are uncommon in patients with LVADs; however, bioprosthetic aortic valve dysfunction can develop less than 1 year after LVAD implantation.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"403-408"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Harvi Cardiovascular Modeling Accurately Predicts Hemodynamic Improvements Produced by a New Direct Cardiac Compression Device. 哈维心血管模型准确预测了一种新的直接心脏压迫装置所产生的血液动力学改善。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2024-11-22 DOI: 10.1097/MAT.0000000000002346

Erica C Perez, Christina M Bolch, Reagan M Tompkins, Daniel Burkhoff, George V Letsou, John C Criscione

{"title":"Harvi Cardiovascular Modeling Accurately Predicts Hemodynamic Improvements Produced by a New Direct Cardiac Compression Device.","authors":"Erica C Perez, Christina M Bolch, Reagan M Tompkins, Daniel Burkhoff, George V Letsou, John C Criscione","doi":"10.1097/MAT.0000000000002346","DOIUrl":"10.1097/MAT.0000000000002346","url":null,"abstract":"Despite advancements in mechanical circulatory support (MCS) technology, persistent critical complications related to blood contact remain unresolved. To provide a safer alternative therapy, CorInnova is developing a non-blood contacting direct cardiac compression (DCC) device for MCS. To support product development toward clinical trials, a simulation platform has been developed to predict clinical outcomes under patient-specific conditions, guiding patient selection for clinical trials. The Harvi simulation was validated using preclinical in vivo data from experimental studies with the CorInnova device, with n = 28 hemodynamic samples simulated from animal data (n = 4 ovine). After confirming validation, further simulation was performed to predict additional hemodynamic outcomes not captured in animal studies. The simulated effects of CorInnova device therapy were not significantly different from animal data for cardiac output, systemic arterial blood pressure, mean pulmonary artery pressure, central venous pressure, or left ventricular pressure ( p > 0.050). Harvi accurately predicts the effects of the CorInnova device in heart failure conditions and can be used in preparation for future clinical trials.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"370-378"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mortality and Complications in Hybrid Extracorporeal Membrane Oxygenation: A Meta-Analysis of Initial Use Versus Transition. 混合体外膜氧合的死亡率和并发症：初始使用与过渡的荟萃分析。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2025-02-13 DOI: 10.1097/MAT.0000000000002392

Irin Shin, Haein Ryu, Yujeong Hou, Mi Sung Kim, Sandy Jeong Rhie

{"title":"Mortality and Complications in Hybrid Extracorporeal Membrane Oxygenation: A Meta-Analysis of Initial Use Versus Transition.","authors":"Irin Shin, Haein Ryu, Yujeong Hou, Mi Sung Kim, Sandy Jeong Rhie","doi":"10.1097/MAT.0000000000002392","DOIUrl":"10.1097/MAT.0000000000002392","url":null,"abstract":"Hybrid extracorporeal membrane oxygenation (ECMO), containing additional ECMO cannulations in addition to conventional ECMO, is increasingly used for the treatment of serious cardiopulmonary conditions. Patients initiating non-hybrid ECMO may transition to hybrid ECMO as their condition worsens. This study compared mortality rates between patients initially on hybrid ECMO and those who transitioned from non-hybrid to hybrid ECMO. We also examined complications related to hybrid ECMO, comparing them with those of non-hybrid ECMO. Data from PubMed, Embase, and Cochrane databases were analyzed using Peto odds ratios and 95% confidential intervals (CIs), with an additional safety comparison to the Extracorporeal Life Support Organization registry to overcome the small number of selected studies. A meta-analysis was performed using review manager. The mortality rate did not differ significantly between whether the hybrid ECMO was used initially or transitioned from non-hybrid ECMO during treatment. Renal-related complications were the most frequent in both hybrid and non-hybrid ECMO cases, with overall higher complication rates in hybrid ECMO. The study concludes that transitioning to hybrid ECMO during treatment does not increase mortality compared to starting with hybrid ECMO, but potential complications, especially with commodity conditions, should be considered. This study provides valuable guidance for clinicians choosing ECMO modalities in clinical practice.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"363-369"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Machine Learning Assisted Stroke Prediction in Mechanical Circulatory Support: Predictive Role of Systemic Mitochondrial Dysfunction. 机械循环支持中的机器学习辅助中风预测：全身性线粒体功能障碍的预测作用。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2025-05-01 Epub Date: 2024-10-22 DOI: 10.1097/MAT.0000000000002340

Jacob P Scioscia, Ivan Murrieta-Alvarez, Shiyi Li, Zicheng Xu, Guangyao Zheng, Jason Uwaeze, Carl P Walther, Zachary Gray, Katherine V Nordick, Vladimir Braverman, Alexis E Shafii, Gabriel Loor, Camila Hochman-Mendez, Ravi K Ghanta, Subhasis Chatterjee, O Howard Frazier, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal

{"title":"Machine Learning Assisted Stroke Prediction in Mechanical Circulatory Support: Predictive Role of Systemic Mitochondrial Dysfunction.","authors":"Jacob P Scioscia, Ivan Murrieta-Alvarez, Shiyi Li, Zicheng Xu, Guangyao Zheng, Jason Uwaeze, Carl P Walther, Zachary Gray, Katherine V Nordick, Vladimir Braverman, Alexis E Shafii, Gabriel Loor, Camila Hochman-Mendez, Ravi K Ghanta, Subhasis Chatterjee, O Howard Frazier, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal","doi":"10.1097/MAT.0000000000002340","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002340","url":null,"abstract":"Stroke continues to be a major adverse event in advanced congestive heart failure (CHF) patients after continuous-flow left ventricular assist device (CF-LVAD) implantation. Abnormalities in mitochondrial oxidative phosphorylation (OxPhos) have been critically implicated in the pathogenesis of neurodegenerative diseases and cerebral ischemia. We hypothesize that prior stroke may be associated with systemic mitochondrial OxPhos abnormalities, and impaired more in post-CF-LVAD patients with risk of developing new stroke. We studied 50 CF-LVAD patients (25 with prior stroke, 25 without); OxPhos complex proteins (complex I [C.I]-complex V [C.V]) were measured in blood leukocytes. Both at baseline (pre-CF-LVAD) and postoperatively (post-CF-LVAD), the prior-stroke group had significantly lower C.I, complex II (C.II), complex IV (C.IV), and C.V proteins when compared to the no-prior-stroke group. Oxidative phosphorylation proteins were significantly decreased in prior-stroke group at post-CF-LVAD compared to pre-CF-LVAD. Machine learning Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest modeling identified six prognostic factors that predicted postoperative stroke with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.93. Oxidative phosphorylation protein reduction appeared to be associated with the new stroke after implantation. Our study found for the first time the existence of mitochondrial dysfunction at the peripheral level in CHF patients with prior ischemic stroke even before CF-LVAD implantation. The changes in OxPhos protein expression could serve as biomarkers in predicting new post-CF-LVAD strokes.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":"71 5","pages":"387-394"},"PeriodicalIF":3.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0