Systemic Inflammatory Response Syndrome After Contentious-Flow Left Ventricular Assist Device Implantation and Change in Platelet Mitochondrial Membrane Potential

J Card Fail. 2015 Jul;21(7):564-71. doi: 10.1016/j.cardfail.2015.04.007. Epub 2015 Apr 25.


Background: The objective of this study was to investigate the change of platelet function and platelet mitochondrial membrane potential in contentious-flow left ventricular assist device (CF-LVAD)-implanted heart failure (HF) patients with or without systemic inflammatory response syndrome (SIRS).

Methods and results: We recruited 31 CF-LVAD patients (16 SIRS and 15 non-SIRS) and 11 healthy volunteers as control. Pre- and post-implantation blood samples were collected. We used PFA-100 to test platelet functionality. Mitochondrial potential-sensitive dye was used to detect platelet dysfunction (mitochondrial membrane potential; ΔΨm) via flow cytometry. The percentage of depolarized-ΔΨm platelets was found to be a preexisting condition in all HF patients before CF-LVAD implantation compared with control subjects (10.3 ± 6.3% vs 2.8 ± 2.2%; P < .001). As evident from the PFA-100 test, the HF patients who developed SIRS after CF-LVAD implantation had significantly more qualitative platelet defects and thrombocytopathies compared with baseline. After implantation, the depolarized platelets in the SIRS patients increased by 2-fold compared with baseline (18.2 ± 8.4% vs 9.0 ± 6.6%; P < .01); whereas no change was noticed in the non-SIRS patients (10.9 ± 6.2% vs 11.7 ± 5.8%; P = .75).

Conclusions: We identified that platelet function and mitochondrial damage were enhanced in CF-LVAD patients with SIRS. Our findings suggest that depolarization of mitochondrial membrane potential is associated with SIRS after CF-LVAD implantation surgery.

Keywords: Heart failure; left ventricular assist device; platelet mitochondrial dysfunction; systemic inflammatory response syndrome.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Blood Platelet Disorders* / complications
  • Blood Platelet Disorders* / diagnosis
  • Blood Platelet Disorders* / metabolism
  • Blood Platelets / metabolism*
  • Female
  • Heart Failure* / blood
  • Heart Failure* / complications
  • Heart Failure* / physiopathology
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Male
  • Membrane Potential, Mitochondrial*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Perioperative Care / methods
  • Platelet Function Tests / methods
  • Severity of Illness Index
  • Statistics as Topic
  • Systemic Inflammatory Response Syndrome* / blood
  • Systemic Inflammatory Response Syndrome* / etiology