Key result
Pulsatile speed modes of RBP and EECP increased pulse pressure and peak wall shear stress compared with the constant speed mode of RBP in computational models of the carotid artery.
Why the study?
Reduced pulsatility from continuous-flow rotary blood pumps may exacerbate compromised baroreceptor response in advanced heart failure, which might be mitigated by pulsatile speed modulation or enhanced external counterpulsation.
Do pulsatile speed modulation algorithms for RBP or EECP improve carotid hemodynamics compared to constant speed RBP in computational models of advanced heart failure?
Do pulsatile speed modulation algorithms for RBP or EECP improve carotid hemodynamics compared to constant speed RBP in computational models of advanced heart failure?
Computational modeling suggests that adding pulsatility to rotary blood pumps or using EECP enhances carotid artery hemodynamics, which may mitigate compromised baroreceptor responses in advanced heart failure.
Answers are grounded in this paper and cite their sources.
Differential carotid hemodynamics with pulsatile RBP modulation or EECP in patient-specific HF models; leaves open optimal baroreflex restoration strategy.
Patients with advanced heart failure have compromised baroreceptor response, which may be exacerbated by the reduced pulsatility due to the constant pump speed when implanted with the continuous flow rotary blood pumps (RBP). This may be mitigated by increasing pulsatility using the pulsatile speed modulation algorithms for RBP or using an enhanced external counterpulsation (EECP). This work quantitatively elucidated the varying hemodynamic effects of the patient-specific models of carotid artery between RBP and EECP support using computational fluid dynamics. Pressure distribution, wall shear stress (WSS), time-averaged WSS (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT) were calculated. Numerical simulation results showed that both pulsatile speed modes of RBP and EECP clearly increased pulse pressure and peak WSS compared with the constant speed mode of RBP, enhanced peak blood perfusion, and may increase the stimulation of the endothelial stretch and shear responses. Moreover, the pulsatile speed mode of RBP generated the highest TAWSS, the EECP resulted in the highest OSI value, and RRT under all the conditions was basically the same. The enhancement of pulsatility and stretch in the carotid artery could minimize the adverse effects of compromised baroreceptor response in patients with advanced heart failure.
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Wang et al. (2025) studied Advanced heart failure. Pulsatile speed modulation algorithms for RBP or enhanced external counterpulsation (EECP) vs. Constant speed mode of RBP was evaluated on Pressure distribution, wall shear stress (WSS), time-averaged WSS (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT). Pulsatile speed modes of RBP and EECP increased pulse pressure and peak wall shear stress compared with the constant speed mode of RBP in computational models of the carotid artery.
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