Endocrine function is not impaired in patients with a continuous MicroMed–DeBakey axial flow pump

Wieselthaler, Georg M.; Riedl, Michaela; Schima, Heinrich; Wagner, Oswald; Waldhäusl, Werner; Wolner, Ernst; Luger, Anton; Clodi, Martin

doi:10.1016/j.jtcvs.2003.03.006

« Previous Next »The Journal of Thoracic and Cardiovascular Surgery
Volume 133, Issue 1 , Pages 2-6, January 2007

Endocrine function is not impaired in patients with a continuous MicroMed–DeBakey axial flow pump

Georg M. Wieselthaler, MD
- Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiosurgical Research, University of Vienna, Vienna, Austria.
Michaela Riedl, MD
- Department of Medicine III, Clinical Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
Heinrich Schima, PhD
- Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiosurgical Research, University of Vienna, Vienna, Austria.
Oswald Wagner, MD
- Department of Laboratory Diagnostics, University of Vienna, Vienna, Austria
Werner Waldhäusl, MD
- Department of Medicine III, Clinical Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
Ernst Wolner, MD
- Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiosurgical Research, University of Vienna, Vienna, Austria.
Anton Luger, MD
- Department of Medicine III, Clinical Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
Martin Clodi, MD
- Department of Medicine III, Clinical Division of Endocrinology and Metabolism, University of Vienna, Vienna, Austria
- Address for reprints: Martin Clodi, MD, Department of Medicine III, Clinical Division of Endocrinology and Metabolism, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

Received 12 July 2002; received in revised form 13 January 2003; accepted 13 March 2003.

Objectives

Pulsatile blood flow has been regarded to be of importance for the regulation of endocrine organs. A new generation of continuous flow mechanical blood pumps is now available for clinical application. Patients with implanted MicroMed-DeBakey axial pumps show nonphysiologic low-pulsatile blood flow profiles, and therefore it appeared to be of interest to evaluate their possible effect on the endocrine system.

Methods

Eight male patients and 1 female patients (mean age, 51 ± 10 years) with end-stage left-sided heart failure were implanted with a MicroMed-DeBakey axial pump. After a mean period of 67 ± 19 days, basal pituitary hormone concentrations and their responses to a bolus injection of hypothalamic releasing hormones were tested. In addition, thyroid hormones, testosterone, and plasma and urinary catecholamine levels were measured at baseline.

Results

Administration of the hypothalamic releasing hormones revealed normal responses of all pituitary hormones (adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone, and prolactin), except for growth hormone, the response of which was slightly impaired (10.2 ± 6.8 vs 19.9 ± 6.5 ng/L, P < .05). Also, the cortisol response to the corticotropin-releasing hormone–stimulated adrenocorticotropic hormone release was normal, as were basal concentrations of thyroid hormones (triiodothyronine, thyroxine, free triiodothyronine, and free thyroxine), testosterone, and urinary catecholamines.

Conclusions

Implantation of a continuous flow axial pump with low-pulsatile blood flow profile appears to have no major effect on the hypothalamic-pituitary-endorgan system and sympathoadrenal functions. This finding is reassuring for the growing number of patients treated with this convenient new pump and could contribute considerably to their prognosis and quality of life.

CTSNet classification: 27

Abbreviations and Acronyms: ACTH, adrenocorticotropic hormone, CRH, corticotropin-releasing hormone, GH, growth hormone, LH, luteinizing hormone, T3, triiodothyronine, T4, thyroxine, TSH, thyroid-stimulating hormone