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Imbalances in Cardiac Output

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...

Pathophysiology of Heart Failure

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...

Pathophysiology of Cardiac Performance

Pathophysiology of Cardiac Performance

Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...

Anatomy of the Heart

Anatomy of the Heart

The human heart is made up of three layers of tissue that are surrounded by the pericardium, a membrane that protects and confines the heart. The outermost layer, closest to the pericardium, is the epicardium. The pericardial cavity separates the pericardium from the epicardium. Beneath the epicardium is the myocardium, the middle layer, and the endocardium, the innermost layer. There are four chambers of the heart: the right atrium, the right ventricle, the left atrium, and the left ventricle.

Cardiac Output II: Effect of Stroke Volume on Cardiac Output

Cardiac Output II: Effect of Stroke Volume on Cardiac Output

Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...

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Updated: Jul 7, 2025

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

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Left Ventricular Assist Device Pump Obstruction Reduces Native Heart Efficiency.

Ricardo Montes¹, Saniya Salim Ueckert¹, Vi Vu¹

¹Bioengineering Program, San Diego State University, San Diego, CA 92182, USA.

Bioengineering (Basel, Switzerland)

|December 23, 2023

Summary

This summary is machine-generated.

Progressive obstruction in left ventricular assist device (LVAD) inflow pathways significantly reduces cardiac function and increases thromboembolic risk. Early detection of these obstructions is crucial for timely intervention and improved patient outcomes.

Keywords:

LVAD flow heart thrombus ventricle vortex

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Area of Science:

Biomedical Engineering
Cardiovascular Physiology
Medical Device Research

Background:

Left ventricular assist devices (LVADs) are crucial for end-stage heart failure treatment.
Obstruction in the LVAD flow path, caused by thrombus or tissue overgrowth, can lead to serious complications like embolism and stroke.
Understanding the hemodynamic impact of LVAD obstruction is vital for patient management.

Purpose of the Study:

To quantify the effects of progressive pump inflow obstruction on pressure and flow dynamics in LVAD-supported hearts.
To investigate the influence of obstruction on native heart function and intraventricular flow patterns.
To identify potential indicators for early detection of LVAD obstruction.

Main Methods:

Utilized a mock circulatory loop to simulate LVAD function under controlled conditions.
Introduced progressive pump obstruction (PO) by gradually occluding the LVAD inlet area.
Measured pressures, flows, and left ventricular (LV) midplane velocity fields across varying LVAD speeds and PO levels.

Main Results:

Increasing pump obstruction led to decreased pressures and flows within the LVAD system.
A significant portion of flow was diverted through the aortic valve, reducing total flow by 6-11%.
Native heart efficiency decreased by up to 60%, with restricted diastolic LVAD flow, reduced mitral inflow, and weakened intraventricular vortices.

Conclusions:

LVAD pump obstruction alters intraventricular flow architecture, promoting flow stasis and increased shear stress, thereby increasing thromboembolic risk.
The observed changes in flow dynamics and reduced cardiac efficiency highlight the clinical significance of LVAD obstruction.
Analyzing the contributions to external work may offer a method for early detection, enabling therapeutic intervention to prevent device failure and complications.