A Multi-Domain Simulation Study of a Pulsatile-Flow Pump Device for Heart Failure With Preserved Ejection Fraction

Area of Science:

• Cardiovascular Engineering
• Biomedical Engineering
• Heart Failure Research

Background:

• Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left atrial pressure.
• Current mechanical circulatory support (MCS) devices primarily offer continuous-flow support.
• The potential benefits of pulsatile support for HFpEF physiology remain largely unexplored.

Purpose of the Study:

• To investigate the efficacy of a pulsatile pump MCS device with left atrial cannulation for HFpEF.
• To evaluate the impact of pulsatile support on left atrial pressure and overall cardiac hemodynamics in HFpEF.
• To compare the physiological effects of pulsatile versus continuous-flow support in HFpEF.

Main Methods:

• Utilized lumped-parameter modeling for pulsatile pump design optimization.
• Employed computational fluid dynamics (CFD) for hydraulic and hemolytic performance assessment.
• Applied finite element modeling with the Living Heart Model to analyze hemodynamic and biomechanical effects.

Main Results:

• Pulsatile-flow support effectively reduced elevated pressures and wall stresses within the left heart.
• The pulsatile device demonstrated more physiologic arterial hemodynamics compared to continuous-flow support.
• Simulations indicated successful alleviation of left atrial pressure in the HFpEF model.

Conclusions:

• Pulsatile support MCS devices demonstrate potential for improving HFpEF patient physiology.
• This study provides a strong foundation for the continued development of pulsatile MCS for HFpEF.
• Pulsatile support may offer advantages over continuous-flow in managing HFpEF hemodynamics.