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The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

Gastrointestinal angiodysplasia in heart failure and during CF LVAD support

Published:November 14, 2021DOI:https://doi.org/10.1016/j.healun.2021.11.009
      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.

      Abbreviations:

      CF LVAD (Continuous Flow Left Ventricular Assist Device), GI (Gastrointestinal), AGD (Angiodysplasia), HFrEF (Heart Failure reduced Ejection Fraction), VCE (Video Capsule Endoscopy)
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