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Ventricular contractility and compliance measured during axial flow blood pump support: In vitro study

机译:轴流血泵支持期间测量的心室收缩力和顺应性:体外研究

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End-systolic elastance and end-diastolic compliance have been used to quantify systolic and diastolic function of the left ventricle (LV). In this study, the effective end-systolic elastance, (EES)eff, end-systolic volume intercept, (V0)eff, and end-diastolic compliance of the LV were assessed at various levels of left ventricular assist device (LVAD) support. We tested the hypothesis that (EES)eff and (V0)eff vary as a function of LVAD speed, while compliance does not change. The Penn State in vitro cardiac simulator was used in two heart conditions (control and heart failure [HF]) with the HeartMate II axial flow LVAD. The LVAD speed was linearly increased from 6000 to 11000 rpm, with 500-rpm increments. The end-systolic and end-diastolic pressure-volume relationships were estimated at each LVAD speed. Acute LVAD support itself showed pseudo-improvement of ventricular contractility. The (EES)eff and (V0)eff in HF were found to be dependent on the LVAD speed. The effective compliance for both control and HF was independent of the LVAD speed. Therefore, when examining the time-course cardiac recovery induced by the LVAD support, LV performance should be measured immediately before and after LVAD support while keeping LVAD speed consistent to avoid potential overestimation of long-term cardiac recovery.
机译:收缩末期弹性和舒张末期顺应性已用于量化左心室(LV)的收缩和舒张功能。在这项研究中,在不同水平的左心辅助装置(LVAD)支持下评估了有效的收缩末期弹性(EES)eff,收缩末期容积拦截(V0)eff和舒张末期顺应性。我们检验了以下假设:(EES)eff和(V0)eff作为LVAD速度的函数而变化,而依从性不变。使用HeartMate II轴向血流LVAD在两种心脏疾病(对照和心力衰竭[HF])中使用Penn State体外心脏模拟器。 LVAD速度从6000 rpm线性增加到11000 rpm,增量为500 rpm。在每种LVAD速度下估计收缩末期和舒张末期压力-容积的关系。急性LVAD支持本身显示出心室收缩的假性改善。发现HF中的(EES)eff和(V0)eff取决于LVAD速度。控制和HF的有效顺应性与LVAD速度无关。因此,在检查由LVAD支持引起的随时间变化的心脏恢复时,应在LVAD支持前后立即测量LV性能,同时保持LVAD速度恒定,以避免潜在地高估长期心脏恢复。

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