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Effects of mechanical left ventricular support on right ventricular diastolic function
M R Moon1, A DeAnda, L J Castro
1Department of Cardiovascular and Thoracic Surgery, Stanford University School of Medicine, California 94305-5247, USA.
Summary
Left ventricular assist device (LVAD) support does not impact right ventricular (RV) diastolic function. RV ischemia impairs RV relaxation and decreases chamber stiffness, but LVAD support does not alter these effects.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Medical Devices
Background:
- Left ventricular unloading with LVADs is known to affect RV systolic function.
- The impact of LVAD support on right ventricular diastolic function remains understudied in intact subjects.
Purpose of the Study:
- To investigate the effects of LVAD support on right ventricular diastolic function in the presence and absence of RV ischemia.
- To assess RV myocardial relaxation, chamber stiffness, and filling dynamics.
Main Methods:
- Seven dogs underwent LVAD implantation and right coronary artery occlusion to induce RV ischemia.
- RV diastolic function was assessed using time constant of isovolumic pressure decay (tau), end-diastolic pressure-volume relation slope, and filling rates.
- Measurements were taken with LVAD off and on, during control conditions and RV ischemia.
Main Results:
- LVAD support alone did not alter RV relaxation, diastolic stiffness, or filling rates.
- RV ischemia significantly impaired RV relaxation (increased tau) and decreased diastolic stiffness.
- LVAD support during RV ischemia did not further affect RV diastolic parameters.
Conclusions:
- RV ischemia negatively impacts RV diastolic function, specifically relaxation and stiffness.
- LVAD support does not influence RV diastolic performance, even during RV ischemia.
- Findings suggest RV diastolic function is preserved despite LVAD support under these experimental conditions.