scholarly journals The Partial Support of the Left Ventricular Assist Device Shifts the Systemic Cardiac Output Curve Upward in Proportion to the Effective Left Ventricular Ejection Fraction in Pressure-Volume Loop

2020 ◽  
Vol 7 ◽  
Author(s):  
Takamori Kakino ◽  
Keita Saku ◽  
Takuya Nishikawa ◽  
Kenji Sunagawa
Keyword(s):  
Cardiac Output ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Output Curve ◽  
Partial Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Left Ventricular Assist ◽  
Curve Upward

Prevalence of exertional oscillatory ventilation in continuous-flow left ventricular assist device recipients

2018 ◽  
Vol 25 (17) ◽  
pp. 1838-1842 ◽  
Author(s):  
Massimo Pistono ◽  
Marco Gnemmi ◽  
Alessandro Imparato ◽  
Klara Komici ◽  
Ugo Corrà
Keyword(s):  
Heart Failure ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Assist Device ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Oscillatory Ventilation ◽  
Left Ventricular Assist

Background Exercise oscillatory ventilation is an ominous outcome sign in heart failure due to reduced left ventricular ejection fraction; currently, the prevalence of exercise oscillatory ventilation is unknown in left ventricular assist device recipients. Methods We studied cardiopulmonary exercise testing in heart failure due to reduced left ventricular ejection fraction or left ventricular assist device patients and exercise oscillatory ventilation was defined according to Kremser's criteria. Results The occurrence of exercise oscillatory ventilation was similar in either heart failure due to reduced left ventricular ejection fraction (192 patients, 8%) or left ventricular assist device patients (85 recipients, 10%), even though the mean peak oxygen consumption and elevated ventilatory response to exercise slope was lower and higher in left ventricular assist device recipients, respectively, but the occurrence of exercise oscillatory ventilation was comparable among heart failure patients due to reduced left ventricular ejection fraction and left ventricular assist device, if those with impaired exercise capacity were considered. Of note, left ventricular assist device recipients with exercise oscillatory ventilation had a higher end-diastolic left ventricular volume and systolic pulmonary artery pressure at rest. Conclusions Using the largest cohort of left ventricular assist device patients performing cardiopulmonary exercise testing, we demonstrated that the occurrence of exercise oscillatory ventilation is similar in heart failure due to reduced left ventricular ejection fraction and left ventricular assist device patients. Recipients with exercise oscillatory ventilation might have haemodynamic and ventilatory dysfunction during exercise, but other factors could play a role, i.e. the duration and severity of heart failure before left ventricular assist device implantation together with the coexistence of morbidity.

scholarly journals Acute pancreatitis-induced takotsubo cardiomyopathy and cardiogenic shock treated with a percutaneous left ventricular assist device

2018 ◽  
pp. bcr-2018-225877 ◽  
Author(s):  
Andree H Koop ◽  
Ryan E Bailey ◽  
Philip E Lowman
Keyword(s):  
Acute Pancreatitis ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Cardiogenic Shock ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Assist Device ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Left Ventricular Assist

A 63-year-old man was admitted for severe acute pancreatitis. On day 3 of hospitalisation, he developed shortness of breath and acute pulmonary oedema. Echocardiogram revealed global hypokinesis with a left ventricular ejection fraction of 20%, and he was diagnosed with takotsubo cardiomyopathy. He developed cardiogenic shock which was treated successfully with a percutaneous left ventricular assist device. His left ventricular ejection fraction improved by hospital follow-up 3 weeks later.

P6589Genetic risks for arrhythmia phenotypes in dilated cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Gigli ◽  
M Merlo ◽  
S Graw ◽  
G Barbati ◽  
T Rowland ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Ventricular Arrhythmias ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Gene Variants ◽  
Assist Device ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Left Ventricular Assist

Abstract Background Genotype-phenotype correlations in dilated cardiomyopathy (DCM) and in particular the effects of gene variants on clinical outcomes remain poorly understood. Purpose To investigate the prognostic role of genetic variant carrier status in a large cohort of DCM patients. Methods We analyzed 487 DCM patients by next-generation sequencing and categorized the disease genes into functional gene groups. The following composite outcome measures were assessed: 1) all-cause mortality, heart transplantation or left ventricular assist device (D/HTx/VAD); 2) sudden cardiac death or malignant ventricular arrhythmias (SCD/MVAs); 3) heart failure related death, heart transplantation or left ventricular assist device implantation (DHF/HTx/VAD). Results A total of 187 pathogenic/likely pathogenic variants were found in 180 patients (37%): 55 (11%) TTN; 19 (4%) LMNA; 24 (5%) structural cytoskeleton-Z disk genes; 16 (3%) desmosomal genes; 47 (10%) sarcomeric genes; 8 (2%) ion channels genes; 11 (2%) other genes. The occurrence of D/HTx/VAD was no different between variant carriers and non-carriers (p=0.17). However, carriers of desmosomal and LMNA variants experienced the highest rate of SCD/MVA, which was independent of the left ventricular ejection fraction. Conclusions Desmosomal and LMNA gene variants identify the subset of DCM patients at greatest risk for SCD and life-threatening ventricular arrhythmias, regardless the left ventricular ejection fraction. Acknowledgement/Funding National Institutes of Health grants R01 HL69071, HL116906, and AHA17GRNT33670495

scholarly journals Outcomes of severe peripartum cardiomyopathy and mechanical circulatory support: a case series

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuki Kiriyama ◽  
Yuki Kinishi ◽  
Daisuke Hiramatu ◽  
Akinori Uchiyama ◽  
Yuji Fujino ◽  
...  
Keyword(s):  
Case Series ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Left Ventricular Ejection ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Social Lives ◽  
Left Ventricular Assist

Abstract Background We present three cases of severe peripartum cardiomyopathy (PPCM) that required mechanical circulatory supports. Case presentation Case 1: A 33-year-old woman developed acute heart failure (AHF) after normal spontaneous delivery. Intra-aortic balloon pump (IABP) was inserted on postpartum day (PD) 10 with a peripartum cardiomyopathy (PPCM), which was withdrawn on PD 30 after medical treatment including anti-prolactin drugs. Case 2: A 44-year-old woman developed AHF 1 month after vaginal delivery. IABP or extra-corporeal membrane oxygenation (ECMO) was not effective and a biventricular assist device was inserted. It was withdrawn on PD 85 after improvement of left ventricular ejection fraction (LVEF). Case3: A 37-year-old woman was transferred with a diagnosis of PPCM. Cardiac function unimproved by IABP or ECMO, and a left ventricular assist device was implanted. It was withdrawn on PD 386 after recovery of LVEF. Conclusion All the cases with PPCM recovered after mechanical circulatory supports and resumed social lives.

scholarly journals Prospective Multicenter Study of Myocardial Recovery Using Left Ventricular Assist Devices (RESTAGE-HF [Remission from Stage D Heart Failure])

Circulation ◽  
2020 ◽  
Vol 142 (21) ◽  
pp. 2016-2028 ◽  
Author(s):  
Emma J. Birks ◽  
Stavros G. Drakos ◽  
Snehal R. Patel ◽  
Brian D. Lowes ◽  
Craig H. Selzman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Myocardial Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Assist Device ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Pulmonary Capillary ◽  
Left Ventricular Assist ◽  
Wedge Pressure

Background: Left ventricular assist device (LVAD) unloading and hemodynamic support in patients with advanced chronic heart failure can result in significant improvement in cardiac function allowing LVAD removal; however, the rate of this is generally considered to be low. This prospective multicenter nonrandomized study (RESTAGE-HF [Remission from Stage D Heart Failure]) investigated whether a protocol of optimized LVAD mechanical unloading, combined with standardized specific pharmacological therapy to induce reverse remodeling and regular testing of underlying myocardial function, could produce a higher incidence of LVAD explantation. Methods: Forty patients with chronic advanced heart failure from nonischemic cardiomyopathy receiving the Heartmate II LVAD were enrolled from 6 centers. LVAD speed was optimized with an aggressive pharmacological regimen, and regular echocardiograms were performed at reduced LVAD speed (6000 rpm, no net flow) to test underlying myocardial function. The primary end point was the proportion of patients with sufficient improvement of myocardial function to reach criteria for explantation within 18 months with sustained remission from heart failure (freedom from transplant/ventricular assist device/death) at 12 months. Results: Before LVAD, age was 35.1±10.8 years, 67.5% were men, heart failure mean duration was 20.8±20.6 months, 95% required inotropic and 20% temporary mechanical support, left ventricular ejection fraction was 14.5±5.3%, end-diastolic diameter was 7.33±0.89 cm, end-systolic diameter was 6.74±0.88 cm, pulmonary artery saturations were 46.7±9.2%, and pulmonary capillary wedge pressure was 26.2±7.6 mm Hg. Four enrolled patients did not undergo the protocol because of medical complications unrelated to the study procedures. Overall, 40% of all enrolled (16/40) patients achieved the primary end point, P <0.0001, with 50% (18/36) of patients receiving the protocol being explanted within 18 months (pre-explant left ventricular ejection fraction, 57±8%; end-diastolic diameter, 4.81±0.58 cm; end-systolic diameter, 3.53±0.51 cm; pulmonary capillary wedge pressure, 8.1±3.1 mm Hg; pulmonary artery saturations 63.6±6.8% at 6000 rpm). Overall, 19 patients were explanted (19/36, 52.3% of those receiving the protocol). The 15 ongoing explanted patients are now 2.26±0.97 years after explant. After explantation survival free from LVAD or transplantation was 90% at 1-year and 77% at 2 and 3 years. Conclusions: In this multicenter prospective study, this strategy of LVAD support combined with a standardized pharmacological and cardiac function monitoring protocol resulted in a high rate of LVAD explantation and was feasible and reproducible with explants occurring in all 6 participating sites. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01774656.

scholarly journals pVAD-assisted left main DK-Crush Bifurcation PCI Post-ViV TAVR

2021 ◽  
Vol 6 (1) ◽  
pp. 029-032
Author(s):  
Das Anshuman ◽  
Maria Planek Isabel Camara ◽  
Attanasio Steve
Keyword(s):  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Left Main ◽  
Assist Device ◽  
Ventricular Assist ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary ◽  
Left Ventricular Assist ◽  
Valve In Valve

We describe successful percutaneous coronary intervention (PCI) of significantly diseased ostial left main (LM) and distal LM bifurcation (Medina 1,1,1) in a patient with a reduced left ventricular ejection fraction and a recent valve-in-valve balloon-expandable TAVR using the DK-Crush technique with the support of a percutaneous left ventricular assist device.

scholarly journals Correlation between Myocardial Function and Electric Current Pulsatility of the Sputnik Left Ventricular Assist Device: In-Vitro Study

2021 ◽  
Vol 11 (8) ◽  
pp. 3359
Author(s):  
Dmitry V. Telyshev ◽  
Alexander A. Pugovkin ◽  
Ivan A. Ephimov ◽  
Aleksandr Markov ◽  
Steffen Leonhardt ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Electric Current ◽  
Left Ventricular Assist Device ◽  
Pulsatility Index ◽  
Myocardial Function ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Cardiac Power ◽  
Left Ventricular Assist

This study assesses the electric current parameters and reports on the analysis of the associated degree of myocardial function during left ventricular assist device (LVAD) support. An assumption is made that there is a correlation between cardiac output and the pulsatility index of the pump electric current. The experimental study is carried out using the ViVitro Pulse Duplicator System with Sputnik LVAD connected. Cardiac output and cardiac power output are used as a measure of myocardial function. Different heart rates (59, 73, 86 bpm) and pump speeds (7600–8400 rpm in 200 rpm steps) are investigated. In our methodology, ventricular stroke volumes in the range of 30–80 mL for each heart rate at a certain pump speed were used to simulate different levels of contractility. The correlation of the two measures of myocardial function and proposed pulsatility index was confirmed using different correlation coefficients (values ≥ 0.91). Linear and quadratic models for cardiac output and cardiac power output versus pulsatility index were obtained using regression analysis of measured data. Coefficients of determination for CO and CPO models were in the ranges of 0.914–0.982 and 0.817–0.993, respectively. Study findings suggest that appropriate interpretation of parameters could potentially serve as a valuable clinical tool to assess myocardial therapy using LVAD infrastructure.

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