Cardiac Index Declines During Long-Term Left Ventricular Device Support

Kalathiya Rohan J.; Houston Brian A.; Chaisson Jordan M.; Grimm Joshua C.; Stevens Gerin R.; Sciortino Christopher M.; Shah Ashish S.; Whitman Glenn J. R.; Russell Stuart D.; Tedford Ryan J.

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Cardiac Index Declines During Long-Term Left Ventricular Device Support

机译：长期左心室设备支持期间心脏指数下降

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To investigate longitudinal trends in valvular and ventricular function with long-term left ventricular assist device (LVAD) therapy, we analyzed hemodynamic and echocardiographic data of patients with at least 2 years of continuous LVAD support. All 130 patients who underwent HeartMate II implantation at our institution between 2005 and 2012 were reviewed. Twenty patients had hemodynamic and echocardiographic evaluations in both the early (0-6 months) and late (2-3 years) postoperative period. Patients on inotropic therapy or temporary mechanical support were excluded. The average times of early and late hemodynamic evaluations were 59641 days and 8896160 days, respectively. Cardiac index (CI) declined by an average of 0.4 L/min/m(2) (P=0.04) with concomitant increase in pulmonary capillary wedge pressure (PCWP; P=0.02). The right atrial pressure to PCWP (RAP: PCWP) ratio decreased during LVAD support suggesting improvement in right ventricular function. While there was an increase in degree of aortic insufficiency (AI) at the late follow-up period (P=0.008), dichotomization by median decline in CI (20.4 L/min/m(2)) indicated no difference in prevalence of AI among the groups. CI declined in patients with HeartMate II after 2 years of continuous support. An increase in preload and afterload was observed in those with the greatest decline in CI.

机译：为了研究长期左心室辅助装置（LVAD）治疗的瓣膜和心室功能的纵向趋势，我们分析了至少2年持续LVAD支持的患者的血流动力学和超声心动图数据。对2005年至2012年间在我们机构接受HeartMate II植入的所有130名患者进行了回顾。二十名患者在术后早期（0-6个月）和晚期（2-3年）均进行了血流动力学和超声心动图评估。进行正性肌力疗法或临时机械支持的患者被排除在外。早期和晚期血流动力学评估的平均时间分别为59641天和8896160天。心脏指数（CI）平均下降0.4 L / min / m（2）（P = 0.04），同时肺毛细血管楔压增加（PCWP; P = 0.02）。 LVAD支持期间右心房压力对PCWP（RAP：PCWP）的比率降低，提示右心室功能得到改善。虽然在随访后期主动脉瓣关闭不全（AI）程度有所增加（P = 0.008），但CI中位数下降（20.4 L / min / m（2））将其二分法表明AI的患病率没有差异组之间。经过连续2年的支持，HeartMate II患者的CI下降。在CI下降幅度最大的人群中，观察到前负荷和后负荷增加。

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《Artificial Organs》 |2016年第12期|共8页
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Kalathiya Rohan J.; Houston Brian A.; Chaisson Jordan M.; Grimm Joshua C.; Stevens Gerin R.; Sciortino Christopher M.; Shah Ashish S.; Whitman Glenn J. R.; Russell Stuart D.; Tedford Ryan J.;
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正文语种 eng
中图分类器官移植术;
关键词
Left ventricular assist device; Hemodynamics; Cardiac index; HeartMate;

机译：左心室辅助装置;血流动力学;心脏指数;HeartMate;

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1. Cardiac Index Declines During Long-Term Left Ventricular Device Support [J] . Kalathiya Rohan J., Houston Brian A., Chaisson Jordan M., Artificial Organs . 2016,第12期

机译：长期左心室设备支持期间心脏指数下降
2. Post-cardiac transplant survival after support with a continuous-flow left ventricular assist device: Impact of duration of left ventricular assist device support and other variables [J] . Ranjit John, Francis D. Pagani, Yoshifumi Naka, The journal of thoracic and cardiovascular surgery . 2010,第1期

机译：连续流量左心室辅助装置支持后的心脏移植术后生存：左心室辅助装置支持持续时间的影响和其他变量
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机译：长期左心室辅助设备支持期间的心脏恢复
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机译：左心室辅助装置支撑下左心室流动动力学的流体结构相互作用模拟
5. The Effects of LVAD Inflow Cannula Diameter, Left Ventricular Geometry, and Cardiac Function on Ventricular Flow [D] . Salim, Saniya Diba 2019

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Cardiac Index Declines During Long-Term Left Ventricular Device Support

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