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Published on: June 12, 2021
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Cardiac function after acute support with direct mechanical ventricular actuation in chronic heart failure
Patrick I McConnell1, Mark P Anstadt, Carlos L Del Rio
1From the *Department of Cardiothoracic Surgery and Research Institute, Nationwide Children's Hospital; †Department of Surgery, The Ohio State University Wexner Medical Center; ‡Department of Surgery and Wright State University, Dayton; and §Qtest Laboratories, Columbus, Ohio.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|September 20, 2014
Summary
Direct mechanical ventricular actuation (DMVA) safely supports failing hearts without blood contact. This 2-hour intervention improved cardiac function and preserved myocardial reserve in dogs with chronic heart failure.
Area of Science:
- Cardiology
- Biomedical Engineering
- Mechanical Circulatory Support
Background:
- Direct mechanical ventricular actuation (DMVA) offers bloodless cardiac support.
- The in vivo safety and efficacy of DMVA in chronic heart failure remain unestablished.
Purpose of the Study:
- To evaluate the acute effects of DMVA on hemodynamics and cardiac function in a canine model of chronic heart failure.
- To assess the impact of DMVA on load-independent systolic and diastolic function, as well as myocardial reserve.
Main Methods:
- Chronic heart failure was induced in seven dogs.
- Hemodynamic and pressure-volume analyses were performed before and after 2 hours of DMVA support.
- Dobutamine challenges assessed myocardial reserve post-support.
Main Results:
- DMVA preserved hemodynamic indices during support.
- Left ventricular systolic and diastolic function improved post-DMVA, indicated by enhanced preload-recruitable stroke work and end-diastolic pressure-volume relationship.
- Diastolic and systolic myocardial reserve were preserved after DMVA.
Conclusions:
- Short-term DMVA support is safe and effective for sustaining hemodynamics in chronic heart failure.
- DMVA favorably impacts cardiac function, particularly preserving load-independent diastolic function and reserve.
- DMVA represents a promising approach for managing chronic heart failure.
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