Key result
Acute LVAD support in an in vitro simulator showed pseudo-improvement of ventricular contractility, with effective end-systolic elastance dependent on LVAD speed, while compliance was independent.
Why the study?
Does LVAD speed affect measured ventricular contractility and compliance in an in vitro heart failure model?
Does LVAD speed affect measured ventricular contractility and compliance in an in vitro heart failure model?
Answers are grounded in this paper and cite their sources.
Acute LVAD support causes speed-dependent pseudo-improvements in measured ventricular contractility, highlighting the need to keep LVAD speed consistent when assessing true cardiac recovery.
End-systolic elastance and end-diastolic compliance have been used to quantify systolic and diastolic function of the left ventricle (LV). In this study, the effective end-systolic elastance, (EES )eff , end-systolic volume intercept, (V0 )eff , and end-diastolic compliance of the LV were assessed at various levels of left ventricular assist device (LVAD) support. We tested the hypothesis that (EES )eff and (V0 )eff vary as a function of LVAD speed, while compliance does not change. The Penn State in vitro cardiac simulator was used in two heart conditions (control and heart failure [HF]) with the HeartMate II axial flow LVAD. The LVAD speed was linearly increased from 6000 to 11 000 rpm, with 500-rpm increments. The end-systolic and end-diastolic pressure-volume relationships were estimated at each LVAD speed. Acute LVAD support itself showed pseudo-improvement of ventricular contractility. The (EES )eff and (V0 )eff in HF were found to be dependent on the LVAD speed. The effective compliance for both control and HF was independent of the LVAD speed. Therefore, when examining the time-course cardiac recovery induced by the LVAD support, LV performance should be measured immediately before and after LVAD support while keeping LVAD speed consistent to avoid potential overestimation of long-term cardiac recovery.
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Jhun et al. (2013) studied Heart failure (simulated). HeartMate II axial flow LVAD vs. Control condition was evaluated on Effective end-systolic elastance, end-systolic volume intercept, and end-diastolic compliance. Acute LVAD support in an in vitro simulator showed pseudo-improvement of ventricular contractility, with effective end-systolic elastance dependent on LVAD speed, while compliance was independent.
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