Document Detail


Left ventricle afterload impedance control by an axial flow ventricular assist device: a potential tool for ventricular recovery.
MedLine Citation:
PMID:  20636446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ventricular assist devices (VADs) are increasingly used for supporting blood circulation in heart failure patients. To protect or even to restore the myocardial function, a defined loading of the ventricle for training would be important. Therefore, a VAD control strategy was developed that provides an explicitly definable loading condition for the failing ventricle. A mathematical model of the cardiovascular system with an axial flow VAD was used to test the control strategy in the presence of a failing left ventricle, slight physical activity, and a recovering scenario. Furthermore, the proposed control strategy was compared to a conventional constant speed mode during hemodynamic changes (reduced venous return and arterial vasoconstriction). The physiological benefit of the control strategy was manifested by a large increase in the ventricular Frank-Starling reserve and by restoration of normal hemodynamics (5.1 L/min cardiac output at a left atrial pressure of 10 mmHg vs. 4.2 L/min at 21 mmHg in the unassisted case). The control strategy automatically reduced the pump speed in response to reduced venous return and kept the pump flow independent of the vasoconstriction condition. Most importantly, the ventricular load was kept stable within 1%, compared to a change of 75% for the constant speed. As a key feature, the proposed control strategy provides a defined and adjustable load to the failing ventricle by an automatic regulation of the VAD speed and allows a controlled training of the myocardium. This, in turn, may represent a potential additional tool to increase the number of patients showing recovery.
Authors:
Francesco Moscato; Maurizio Arabia; Francesco M Colacino; Phornphop Naiyanetr; Guido A Danieli; Heinrich Schima
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-07-15
Journal Detail:
Title:  Artificial organs     Volume:  34     ISSN:  1525-1594     ISO Abbreviation:  Artif Organs     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-01     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  736-44     Citation Subset:  IM    
Copyright Information:
© 2010, Copyright the Authors. Journal compilation © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Affiliation:
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria. francesco.moscato@meduniwien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Blood Volume
Computer Simulation
Feasibility Studies
Heart Failure / physiopathology,  therapy*
Heart-Assist Devices*
Hemodynamics*
Humans
Models, Cardiovascular
Numerical Analysis, Computer-Assisted
Prosthesis Design
Recovery of Function
Time Factors
Vascular Resistance
Vasoconstriction
Ventricular Function, Left*
Ventricular Pressure
Ventricular Remodeling

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


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