For patients who are awaiting a heart transplant, Left Ventricular Assist Devices (LVAD) can literally mean the difference between life and death -- helping the patient's own weakened heart to continue pumping until a suitable donor organ becomes available. In this study, Heart Institute physicians and surgeons note that in addition to assisting the patient's own heart, LVADs can aid obese heart transplant patients in weight reduction. Weight loss in such patients is important because just as obesity is a risk factor for heart failure, it also is associated with poor outcomes after a heart transplant. It is therefore considered a relative contra-indication for transplant.
In this analysis of 19 patients who were awaiting a transplant, obese advanced heart failure patients lost more weight and reduced their body mass index (BMI) significantly after being implanted with an LVAD. Obese patients who received the device lost about 12 percent of their body weight, nearly double the amount of weight lost by patients who were not obese.
According to researchers, the weight loss in patients implanted with the LVAD likely resulted from a combination of factors: the device possibly caused more calories to be consumed while simultaneously also resulting in decreased caloric intake.
While the obese patients were previously very sedentary, the LVAD provided more cardiac capacity, thereby enabling these patients to become more active, improve their overall conditioning, and expend more calories. In addition, the total weight, shape and physical location of the LVAD in the abdomen likely played a role in reducing caloric intake.
"Achieving adequate weight loss appears difficult among obese heart failure patients who are unable to exercise due to de-conditioning and reduced cardiac capacity," said Ernst Schwarz, M.D., Ph.D., director of Multidisciplinary Heart Failure Research at the Cedars-Sinai Heart Institute. "LVADs could prove to be helpful in improving obese patients' outcomes."
This research was presented at the American College of Cardiology's Scientific Session in Atlanta.
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