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Synchronized pulsatile speed control of turbodynamic left ventricular assist devices: Review and prospects

机译：涡轮动力左心辅助设备的同步脉动速度控制：回顾与展望

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Turbodynamic blood pumps are used clinically as ventricular assist devices (VADs). They are mostly operated at a constant rotational speed, which results in a reduced pulsatility. Previous research has analyzed pulsing pump speeds (speed modulation) to alter the interaction between the cardiovascular system and the blood pump. In those studies, sine- or square-wave speed profiles that were synchronized to the natural cardiac cycle were analyzed in silico, in vitro and in vivo. The definitions of these profiles with respect to both timing and speed levels vary among different research groups. The current paper provides a definition of the timing of these speed profiles such that the resulting hemodynamic effects become comparable. The results published in the literature are summarized and compared using this definition. Further, applied to a turbodynamic VAD, a series of measurements is conducted on a hybrid mock circulation using a constant speed as well as different types of square-wave speed profiles and a sine-wave speed profile. When a consistent definition of the timing of the speed profiles is used, the hemodynamic effects observed in previous work are in agreement with the measurement data obtained for the current paper. These findings allow the conclusion that the speed modulation of turbodynamic VADs represents a consistent tool to systematically change the ventricular load and the pulsatility in the arterial tree. The timing that yields the minimal left ventricular load also yields the minimal arterial pulse pressure.
机译：涡轮动力血泵在临床上用作心室辅助设备（VAD）。它们大多以恒定的转速运行，这导致脉动降低。先前的研究已经分析了脉动泵的速度（速度调制），以改变心血管系统与血泵之间的相互作用。在那些研究中，在计算机，体外和体内分析了与自然心动周期同步的正弦波或方波速度曲线。在不同的研究小组中，关于时间和速度水平的这些配置文件的定义有所不同。当前的论文提供了这些速度曲线的定时的定义，以使产生的血液动力学作用变得可比。使用此定义总结并比较了文献中发表的结果。此外，应用于涡轮动力VAD时，使用恒定速度以及不同类型的方波速度曲线和正弦波速度曲线对混合模拟循环进行一系列测量。当使用一致的速度曲线定时定义时，先前工作中观察到的血液动力学效应与当前论文获得的测量数据一致。这些发现可以得出这样的结论，即涡轮动力VAD的速度调制代表了系统地改变心室负荷和动脉树搏动性的一致工具。产生最小左心室负荷的时间也产生最小动脉脉压。

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