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首页> 外文期刊>Artificial Organs >The Effect of LVAD Pressure Sensitivity on the Assisted Circulation Under Consideration of a Mitral Insufficiency: An In Vitro Study
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The Effect of LVAD Pressure Sensitivity on the Assisted Circulation Under Consideration of a Mitral Insufficiency: An In Vitro Study

机译：LVAD压力灵敏度对二尖瓣不足辅助循环的影响：体外研究

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Abstract Current left ventricular assist devices (LVADs) differ with respect to their pump characteristics as described by the pump characteristic curve (also called HQ‐curve). Pressure sensitive LVADs depict a flat characteristic curve while most available LVADs have a steep, less pressure sensitive characteristic curve. This in vitro study investigated the effect of LVAD pressure sensitivity with a focus on the afterload of the right ventricle (RV) which is one out of many factors influencing right heart failure (RHF). To this end, two laboratory pumps differing in pressure sensitivity were tested as LVAD in an established, active mock circulation loop (MCL). The MCL represented patients with left heart failure and mitral insufficiency as another contributing factor to RV afterload. The results show that the pressure‐volume loop (PV‐loop) of the left ventricle (LV) undergoes a leftward and thus somewhat of a downward‐shift for highly pressure sensitive support. Consequently, the LV is unloaded to a higher degree at comparable arterial blood pressure and identical cardiac output, pulmonary and systemic vascular resistance and ventricular contractility. This causes a concomitant decrease of RV afterload. This effect seems to be due to increased unloading during systole. In case of a severe concomitant mitral insufficiency and looking at left atrial pressure, the difference is 18.5%. Without mitral insufficiency, the difference is reduced to 10.2%.
机译：摘要电流左心室辅助装置（LVAD）与泵特性曲线（也称为HQ曲线）的泵特性不同。压力敏感的LVAD描绘了平面特征曲线，而最具可用的LVAD具有陡峭，压力敏感特性曲线。这种体外研究研究了LVAD压力灵敏度的影响，重点是右心室（RV）的后载，这是影响右心力衰竭（RHF）的许多因素中的一个。为此，在已建立的主动模拟循环回路（MCL）中，将两个在压力灵敏度不同的实验室泵作为LVAD进行测试。 MCL代表了左心力衰竭和二尖瓣不足的患者，作为RV后荷载的另一个贡献因素。结果表明，左心室（LV）的压力量环（PV-LOOP）经历向左，从而稍微向下移动以进行高压敏感载体。因此，LV在相当的动脉血压和相同的心输出，肺和全身血管抗性和心室收缩性上卸载至更高程度。这导致RV后荷的伴随减少。这种效果似乎是由于在收缩过程中增加卸载。在严重伴随二尖瓣功能不全的情况下，看着左心房压力，差异是18.5％。没有二尖点不足，差异降至10.2％。

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