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Biventricular Assessment of Cardiac Function and Pressure-Volume Loops by Closed-Chest Catheterization in Mice
Published on: June 15, 2020
Evaluation of native left ventricular function during mechanical circulatory support: theoretical basis and clinical
1Department of Thoracic Organ Replacement, Tokyo Medical and Dental University, Postgraduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Summary
Evaluating left ventricular function in patients with heart disease using echocardiography is inaccurate when they use a left ventricular assist device (LVAD). The left ventricular end-systolic pressure-volume relationship offers a more reliable measure of heart contractility.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Echocardiography is the standard for assessing left ventricular function in heart disease patients.
- Mechanical unloading by left ventricular assist devices (LVADs) renders echocardiography inaccurate for evaluating cardiac function.
- Assessing myocardial recovery is crucial for patients considering LVAD weaning.
Purpose of the Study:
- To discuss the limitations of current methods for evaluating left ventricular function in LVAD patients.
- To highlight the importance of accurately assessing myocardial contractility before LVAD weaning.
- To explore methods for predicting the longevity of recovered cardiac function.
Main Methods:
- Review of current clinical practices for LVAD patients.
- Theoretical analysis of left ventricular contractility assessment.
- Discussion of limitations in evaluating recovering myocardium.
Main Results:
- Echocardiography provides erroneous dimensional changes in LVAD patients due to mechanical unloading.
- The left ventricular end-systolic pressure-volume relationship is theoretically the most reliable measure of left ventricular contractility.
- Unexpected recovery of myocardial contractility allows some patients to be weaned from LVADs.
Conclusions:
- Accurate assessment of left ventricular function is critical before LVAD weaning.
- Predicting the duration of recovered myocardial function is essential for long-term quality of life.
- Further research is needed to refine methods for evaluating recovering myocardium in LVAD patients.
