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Interventricular dyssynchrony during continuous-flow left ventricular assist device support: observation using the

Junichi Shimamura1,2, Takashi Nishimura3, Toshihide Mizuno4

  • 1Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1, Fujishirodai, Suita, Osaka, 565-8565, Japan. junichi.shimamura@gmail.com.

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
|July 4, 2019
PubMed
Summary

Continuous-flow left ventricular assist device (CF-LVAD) support can cause interventricular dyssynchrony, where the left and right ventricles operate out of sync. This study quantified this dyssynchrony using the conductance method in goats.

Keywords:
Conductance methodInterventricular dyssynchronyLeft ventricular assist devicePressure–volume loop

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Area of Science:

  • Cardiovascular Physiology
  • Medical Devices
  • Biomedical Engineering

Background:

  • Continuous-flow left ventricular assist devices (CF-LVADs) are crucial for heart failure management.
  • CF-LVAD support can alter normal cardiac mechanics, potentially leading to interventricular dyssynchrony.
  • Understanding this dyssynchrony is vital for optimizing device performance and patient outcomes.

Purpose of the Study:

  • To investigate and quantify interventricular dyssynchrony induced by CF-LVAD support.
  • To utilize the conductance method for simultaneous pressure-volume analysis of both ventricles.
  • To establish a baseline understanding of dyssynchrony in a normal heart model.

Main Methods:

  • Adult goats (n=5) underwent CF-LVAD implantation.
  • A conductance catheter was inserted into the left and right ventricles to measure pressure-volume loops.
  • Interventricular dyssynchrony was defined by opposing volume changes between the ventricles during the cardiac cycle.

Main Results:

  • Significant interventricular dyssynchrony was observed during CF-LVAD support.
  • Dyssynchronous phases increased from 5.6% (pump-off) to 25.3% (full bypass) (p < 0.05).
  • This study provides the first experimental report on CF-LVAD-induced dyssynchrony using the conductance method.

Conclusions:

  • CF-LVAD support demonstrably causes interventricular dyssynchrony.
  • The conductance method is effective for quantifying this phenomenon.
  • Future research will focus on quantifying dyssynchrony under various support levels and assessing its impact on right ventricular function.