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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Mechanical and interventional support for heart failure with preserved ejection fraction: A review
Jonathan S Gordon1,2, Cameron M Blazoski1, Chelsey T Wood1
1Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Artificial Organs
|May 17, 2022
Summary
Left atrial assist devices show promise for treating heart failure with preserved ejection fraction (HFpEF) in restrictive and hypertrophic cardiomyopathy patients. These devices offer a potential alternative when other therapies fail.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Restrictive cardiomyopathy (RCM) and hypertrophic cardiomyopathy (HCM) can lead to heart failure with preserved ejection fraction (HFpEF).
- Current pharmacologic therapies for HFpEF have shown limited efficacy in improving patient outcomes or reducing mortality.
- There is a significant need for alternative treatment strategies for HFpEF, including surgical and device-based interventions.
Purpose of the Study:
- To explore and report the current utility of percutaneous therapies and surgically implanted mechanical support in treating patients with HFpEF.
- To evaluate novel device-based approaches for managing RCM and HCM.
- To identify promising therapeutic avenues for heart failure with preserved ejection fraction.
Main Methods:
- Review of percutaneous interventions, including interatrial shunts.
- Analysis of left atrial assist devices (LAADs) and ventricular assist devices (VADs) in various configurations.
- Evaluation of the potential of a left atrial-to-aortic VAD and LAADs in the mitral position.
Main Results:
- Ventricular assist devices (VADs) have limited efficacy in patients with RCM and HCM.
- A left atrial-to-aortic VAD has been proposed for direct left atrial unloading, but supporting data is scarce.
- A left atrial assist device (LAAD) in the mitral position could simultaneously unload the left atrium and fill the left ventricle.
Conclusions:
- A left atrial assist device (LAAD) positioned in the mitral valve presents a promising strategy to address hemodynamic issues in RCM and HCM.
- These LAADs are still under development, indicating ongoing research and innovation in the field.
- Further development is required to fully realize the potential of LAADs for treating these specific cardiomyopathies.
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