期刊
ASAIO JOURNAL
卷 67, 期 1, 页码 74-83出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MAT.0000000000001158
关键词
left ventricular assist device; echocardiography; heart failure
资金
- National Institutes of Health/UC Center for Accelerated Innovation
- American Heart Association [NIH NCAI-UCCAI-2017-06-6, AHA 16GRNT27250262]
LVAD therapy is often complicated by issues such as thrombosis and bleeding. This study suggests that noninvasive flow imaging techniques, such as 2D echo color Doppler velocimetry, may be used alongside standard clinical methods to optimize LVAD settings and minimize blood stasis on an individual basis. LVAD support was found to reverse the increase in blood stasis associated with dilated cardiomyopathy, but did not reduce intraventricular shear exposure.
The success of left ventricular assist device (LVAD) therapy is hampered by complications such as thrombosis and bleeding. Understanding blood flow interactions between the heart and the LVAD might help optimize treatment and decrease complication rates. We hypothesized that LVADs modify shear stresses and blood transit in the left ventricle (LV) by changing flow patterns and that these changes can be characterized using 2D echo color Doppler velocimetry (echo-CDV). We used echo-CDV and custom postprocessing methods to map blood flow inside the LV in patients with ongoing LVAD support (Heartmate II, N = 7). We compared it to healthy controls (N = 20) and patients with dilated cardiomyopathy (DCM, N = 20). We also analyzed intraventricular flow changes during LVAD ramp tests (baseline +/- 400 rpm). LVAD support reversed the increase in blood stasis associated with DCM, but it did not reduce intraventricular shear exposure. Within the narrow range studied, the ventricular flow was mostly insensitive to changes in pump speed. Patients with significant aortic insufficiency showed abnormalities in blood stasis and shear indices. Overall, this study suggests that noninvasive flow imaging could potentially be used in combination with standard clinical methods for adjusting LVAD settings to optimize flow transport and minimize stasis on an individual basis.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据