Physiological and hemodynamic evaluation of nonuniform direct cardiac compression

Area of Science:

• Cardiovascular Physiology
• Biomedical Engineering
• Heart Failure Research

Background:

• Current ventricular assist devices pose risks due to blood/device interfaces.
• Biventricular direct cardiac compression (DCC) offers a bloodless alternative for cardiac support.
• A clinically designed DCC device was developed for synchronised cardiac compression.

Purpose of the Study:

• To evaluate the efficacy of a novel biventricular direct cardiac compression (DCC) device.
• To assess DCC's impact on cardiac function in failing heart models.
• To determine if DCC can mitigate complications of existing ventricular support systems.

Main Methods:

• Ex vivo canine heart preparation with a computerized afterload system.
• In vivo canine model of acute ischemic heart failure induced by coronary artery embolization.
• Testing DCC under various ventricular preloads and simulated heart failure conditions.

Main Results:

• DCC shifted the end-systolic pressure-volume relation upward by approximately 40% of compression pressure.
• In severe heart failure, DCC increased cardiac output (CO) by 104% and mean arterial pressure by 95%.
• CO was restored to about 60% of normal baseline values, demonstrating significant hemodynamic improvement.

Conclusions:

• Nonuniform DCC significantly enhances left and right ventricular pressure generation.
• DCC effectively increases cardiac output and mean arterial pressure in acute heart failure.
• DCC devices present a promising alternative, potentially avoiding blood/device interface complications.