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首页> 外文期刊>Artificial Organs >Speed Modulation of the HeartWare HVAD to Assess In Vitro Hemocompatibility of Pulsatile and Continuous Flow Regimes in a Rotary Blood Pump
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Speed Modulation of the HeartWare HVAD to Assess In Vitro Hemocompatibility of Pulsatile and Continuous Flow Regimes in a Rotary Blood Pump

机译：心脏HVAD的调速调制评估旋转血泵脉动和连续流动制度的体外血液相色

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Abstract Although rotary blood pumps (RBPs) sustain life, blood exposure to continuous supra‐physiological shear stress induces adverse effects (e.g., thromboembolism); thus, pulsatile flow in RBPs represents a potential solution. The present study introduced pulsatile flow to the HeartWare HVAD using a custom‐built controller and compared hemocompatibility biomarkers (i.e., platelet aggregation, concentrations for ADAMTS13, von Willebrand factor (vWf), and free‐hemoglobin in plasma (pfHb), red blood cell (RBC) deformability, and RBC‐nitric oxide synthase?(NOS) activity) between continuous and pulsatile flow in a blood circulation loop over 5 h. The HeartWare HVAD was operated using a custom‐built controller, at?continuous speed (3282 rev/min) or in a pulsatile mode (mean speed?=?3273 rev/min, amplitude?=?430 rev/min, frequency?=?1 Hz) to generate a blood flow rate of 5.0 L/min, HVAD differential pressure of 90 mm Hg for continuous flow and 92 mm Hg for pulsatile flow, and systolic and diastolic pressures of 121/80 mm Hg. For both?flow regimes, the current study found; (i) ADP‐ and collagen‐induced platelet aggregation, and ADAMTS13 concentration significantly decreased after 5 h ( P ??0.01; P ??0.05), (ii) ristocetin‐induced platelet aggregation significantly increased after 45 min ( P ??0.05), (iii) vWf concentration did not significantly differ at any time point, (iv) pfHb significantly increased after 5 h ( P ??0.01), (v) RBC deformability improved during the continuous flow regime ( P ??0.05) but not during pulsatile flow, and (vi) RBC‐NOS activity significantly increased during continuous flow (15 min), and pulsatile flow (5 h; P ??0.05). The current study demonstrated: (i) speed modulation does not improve hemocompatibility of the HeartWare HVAD based on no observable differences being detected for routine biomarkers, and (ii) the time‐course for increased RBC‐NOS activity observed during continuous flow may?have improved RBC deformability.
机译：摘要虽然旋转血液泵（RBPS）维持生命，血液暴露于连续的同上生理剪切应力诱导不良反应（例如，血栓栓塞）;因此，Rbps中的脉动流量代表潜在的解决方案。本研究利用定制的控制器和比较血液相容性生物标志物（即血小板聚集，Adamts13，von Willebrand因子（VWF）和血浆（PFHB），红细胞的自由血红蛋白（即，血小板聚集，Adamts13，von Willebrand因子（VWF）的血栓间聚集（血小板聚集，浓度）来引入脉动流。 （RBC）可变形性和RBC-一氧化氮合酶α（NOS）活性在血液循环回路中连续和脉动流动之间的血液循环循环之间。使用定制控制器操作的心脏HVAD，处于λ连续速度（3282 rev / min）或脉动模式（平均速度？=？3273 Rev / min，幅度？= 430 rev / min，频率？= ？1 Hz）以产生5.0升/分钟，HVAD差压为90mm HV的血液流速，用于连续流动和92mm Hg，用于脉动流动，收缩压和舒张压为121/80mm Hg。对于既有？流动制度，目前的研究发现; （i）ADP-和胶原蛋白诱导的血小板聚集，5小时后，ADAMTS13浓度显着降低（p≤01.01;p≤0.3→0.05），（ii）颗粒诱导的血小板聚集在45分钟后显着增加（ p？＆？0.05），（iii）在任何时间点的VWF浓度没有显着不同，（iv）PfHb在5小时后显着增加（p？Δ01），（v）RBC可变形性在连续流动期间提高制度（p≤≤0.05）但不在脉动流动期间，（VI）RBC-NOS活性在连续流动（15分钟）和脉动流动（5小时;p≤≤0.05）期间显着增加。目前的研究证明：（i）基于常规生物标志物未检测到可观察到的差异，并且（ii）在连续流动期间观察到的RBC-NOS活性增加的时间疗程不会改善心脏HVAD的血液相容性，并且可以在连续流动期间观察到的增加的RBC-NOS活性的时间过程？有改善RBC可变形性。

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