Key result
In a canine computational model, counter-pulsating LVADs decreased left ventricular peak pressure to 10% and ATP consumption to 50%, compared to 46% and 60% with continuous LVADs.
Why the study?
Does counter-pulsating LVAD support improve left ventricular peak pressure and contractile ATP consumption compared to continuous LVAD support in a computational model of failing canine ventricles?
Does counter-pulsating LVAD support improve left ventricular peak pressure and contractile ATP consumption compared to continuous LVAD support in a computational model of failing canine ventricles?
Absolute Event Rate: 50% vs 60%
The small difference in contractile ATP consumption reduction between continuous and counter-pulsating LVADs may explain their comparable clinical effects on myocardial recovery despite larger differences in pressure unloading.
May favor counter-pulsation for unloading in models; hypothesis-generating for clinical myocardial recovery differences.
Left ventricular-assist devices (LVADs) are used to supply blood to the body of patients with heart failure. Pressure unloading is greater for counter-pulsating LVADs than for continuous LVADs. However, several clinical trials have demonstrated that myocardial recovery is similar for both types of LVAD. This study examined the contractile energy consumption of the myocardium with continuous and counter-pulsating LVAD support to ascertain the effect of the different LVADs on myocardial recovery. We used a three-dimensional electromechanical model of canine ventricles, with models of the circulatory system and an LVAD. We compared the left ventricular peak pressure (LVPP) and contractile ATP consumption between pulsatile and continuous LVADs. With the continuous and counter-pulsating LVAD, the LVPP decreased to 46 and 10%, respectively, and contractile ATP consumption decreased to 60 and 50%. The small difference between the contractile ATP consumption of these two types of LVAD may explain the comparable effects of the two types on myocardial recovery.
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Lim et al. (2011) studied Heart failure (computational model). Counter-pulsating LVAD vs. Continuous LVAD was evaluated on Contractile ATP consumption (% of baseline). In a canine computational model, counter-pulsating LVADs decreased left ventricular peak pressure to 10% and ATP consumption to 50%, compared to 46% and 60% with continuous LVADs.
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