Document Detail


Hemodynamic effects of partial ventricular support in chronic heart failure: results of simulation validated with in vivo data.
MedLine Citation:
PMID:  17198776     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Current left ventricular assist devices are designed to provide full hemodynamic support for patients with end-stage failing hearts, but their use has been limited by operative risks, low reliability, and device-related morbidity. Such concerns have resulted in minimum use of left ventricular assist devices for destination therapy. We hypothesize that partial circulatory support, which could be achieved with small pumps implanted with less-invasive procedures, might expand the role of circulatory support devices for treatment of heart failure. METHODS: We examine the hemodynamic effects of partial left ventricular support using a previously described computational model of the cardiovascular system. Results from simulations were validated by comparison with an in vivo hemodynamic study. RESULTS: Simulations demonstrated that partial support (2-3 L/min) increased total cardiac output (left ventricular assist device output plus native heart output) by more than 1 L/min and decreased left ventricular end-diastolic pressure by 7 to 10 mm Hg with moderate-to-severe heart failure. Analyses showed that the hemodynamic benefits of increased cardiac output and decreased left ventricular end-diastolic pressure are greater in less-dilated and less-dysfunctional hearts. Both the relationships between ventricular assist device flow and cardiac output and ventricular assist device flow and left atrial pressure predicted by the model closely approximated the same relationships obtained during hemodynamic study in a bovine heart failure model. CONCLUSIONS: Results suggest that a pump with a flow rate of 2 to 3 L/min could meaningfully affect cardiac output and blood pressure in patients with advanced compensated heart failure. The development of small devices capable of high reliability and minimal complications that can be implanted with less-invasive techniques is supported by these findings.
Authors:
Deborah Morley; Kenneth Litwak; Paul Ferber; Paul Spence; Robert Dowling; Bart Meyns; Bartley Griffith; Daniel Burkhoff
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  133     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-02     Completed Date:  2007-01-30     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  21-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Affairs, CircuLite, Inc, Hackensack, NJ 07601, USA. dmorley@circulite.net
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure
Cardiac Output
Cardiovascular Physiological Phenomena*
Cattle
Computer Simulation
Heart Failure / physiopathology,  therapy*
Heart-Assist Devices*
Humans
Male
Models, Cardiovascular
Ventricular Pressure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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