Document Detail


Cardiac Function after Acute Support with Direct Mechanical Ventricular Actuation in Chronic Heart Failure.
MedLine Citation:
PMID:  25238499     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Direct mechanical ventricular actuation (DMVA) exerts direct cardiac compression/decompression and does not require blood contact. The safety and effects of DMVA support in chronically dysfunctional beating hearts in vivo have not been established. This study evaluated hemodynamics and load-independent systolic/diastolic cardiac function before/after acute support (2 hours) using DMVA in small hearts with induced chronic failure.Chronic heart failure (CHF) was created in 7 small dogs (15 ± 2 Kg) via either serial coronary microembolizations or right-ventricular overdrive pacing. Dogs were instrumented to measure cardiac output, hemodynamic pressures, left ventricular volumes for pressure-volume analysis via preload reduction. Temporary cardiac support using a DMVA device was instituted for 2 hours. Hemodynamic and mechanical assessments, including dobutamine dose-responses, were compared both before and after support.Hemodynamics indices were preserved with support. Both left-ventricular systolic and diastolic function were improved post-support, as the slopes of the preload-recruitable stroke work (+29 ± 7%, P < 0.05) and the end-diastolic pressure volume relationship (EDPVR: -28±9%, P < 0.05) improved post-DMVA support. Diastolic/systolic myocardial reserve, as assessed by responsiveness to dobutamine challenges, was preserved after DMVA support.Short-term DMVA support can safely and effectively sustain hemodynamics, while triggering favorable effects on cardiac function in the setting of chronic heart failure. In particular, DMVA support preserved load-independent diastolic function and reserve.
Authors:
Patrick I McConnell; Mark P Anstadt; Carlos L Del Rio; Thomas J Preston; Yukie Ueyama; Brad L Youngblood
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-18
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  -     ISSN:  1538-943X     ISO Abbreviation:  ASAIO J.     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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