Mechanical shear stress and leukocyte phenotype and function: Implications for ventricular assist device development...

Area of Science:

• Biomedical Engineering
• Hematology
• Cardiology

Background:

• Heart failure prevalence is increasing globally.
• Mechanical circulatory support (MCS) is vital for end-stage heart failure patients, transplant candidates, and during cardiac surgery.
• Complications like infection and thrombosis are significant risks associated with MCS.

Purpose of the Study:

• To review the existing literature on the effects of MCS on leukocyte phenotype and function.
• To highlight the importance of understanding mechanical trauma to leukocytes during MCS.
• To elucidate the role of leukocytes in MCS-related adverse events.

Main Methods:

• Comprehensive literature review of studies investigating MCS and leukocyte interactions.
• Analysis of leukocyte activation, function, and microparticle release under MCS conditions.
• Comparison of leukocyte mechanical trauma with that of erythrocytes and platelets.

Main Results:

• Leukocyte activation, reduced functionality, and release of pro-inflammatory/pro-thrombotic microparticles occur due to foreign surface contact and shear stress from MCS.
• Mechanical trauma to leukocytes is often overlooked compared to other blood components.
• Leukocyte dysfunction contributes to infection and thrombosis risks in MCS patients.

Conclusions:

• Mechanical circulatory support significantly impacts leukocyte phenotype and function.
• Understanding leukocyte mechanical trauma is essential for mitigating adverse events during MCS.
• Further research is needed to address leukocyte-related complications and improve patient outcomes with MCS.