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HeartPatch implanted direct cardiac compression: effect on coronary flow and flow patterns in acute heart failure
Yifei Huang1, Gabrielle Gallagher, Serguei Plekhanov
1Cardiac Technology Centre, Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia.
Insights
Direct cardiac compression (DCC) with the HeartPatch device maintained coronary artery blood flow in sheep with acute heart failure. This novel device shows promise for supporting myocardial perfusion during cardiac distress.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
Background:
- Acute heart failure (HF) significantly impairs cardiac output and coronary circulation.
- The impact of direct cardiac compression (DCC) devices on myocardial perfusion in HF is not well understood.
Purpose of the Study:
- To investigate the effect of the HeartPatch DCC device on coronary artery blood flow (CABF) and its patterns in a sheep model of acute HF.
Main Methods:
- Ten sheep underwent implantation of HeartPatch devices on ventricular free walls.
- Acute HF was induced using esmolol, leading to reduced cardiac output and CABF.
- DCC device activation effects on CABF, flow velocities, and diastolic fraction were analyzed.
Main Results:
- DCC assist did not alter total antegrade CABF despite inducing significant changes in flow patterns.
- Peak antegrade and retrograde flow velocities increased substantially with DCC.
- The proportion of diastolic flow increased significantly, indicating altered coronary flow dynamics.
Conclusions:
- The HeartPatch DCC device effectively supports coronary circulation in acute HF.
- Myocardial perfusion is not compromised by DCC, suggesting its potential therapeutic benefit.
Abstract:
A novel HeartPatch direct cardiac compression (DCC) device has been shown to effectively restore circulatory parameters in sheep with acute heart failure (HF). Its effect on the coronary circulation and myocardial perfusion, however, remains uncertain. The effect of DCC assist on coronary artery blood flow (CABF) and its patterns in acute HF sheep were examined in this study. Ten sheep (51 +/- 6 kg) were implanted with a heart patch on each of the left ventricular and right ventricular free walls 1 week before study. Stable HF [cardiac output (CO) at 51 +/- 8% of baseline] induced by intravenous esmolol resulted in CABF decreasing to 53 +/- 16% of baseline (p < 0.001). DCC device activation did not alter CABF (54 +/- 15% of baseline, N.S.) but was accompanied by increases in both peak antegrade and retrograde flow velocity (161 +/- 75%, p < 0.001 and 413 +/- 377%, p < 0.001). A shift in the proportion of flow occurring in diastole (%DF) also was observed: baseline, 81 +/- 9%; HF, 82 +/- 6%; DCC assist, 121 +/- 16% (p < 0.001). Despite significant changes in coronary artery flow pattern resulting from DCC of the failing heart, total antegrade coronary flow was maintained. These findings suggest that myocardial perfusion is not compromised by DCC.
