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- W2073411400 abstract "Differences in how intra-abdominal axial flow pumps (HMII) and intra-thoracic centrifugal flow pumps (HVAD) unload the left ventricle (LV) when assessed by 2D echocardiography have been noted by several groups. The aim of this study was to compare the extent of LV unloading and differences in LV shape in response to speed changes between HMII and HVAD using geometry-independent measures of LV unloading. Consecutive patients with CF-LVAD underwent RPM ramp tests with simultaneous recording of right heart catheterization (RHC) parameters and 3 Dimentional echo with post processing surface analysis. RHC data pulmonary capillary wedge pressure (PCWP), Fick Cardiac output (CO), and 3D echo assessment of LV and RV volume. Ramp tests were done with increments of 400 RPMs (8000-12000 rpm) for HMII patients and with 100 RPMs (2300-3200 rpm) for HVAD patients. Both HM II and HVAD reduced the PCWP in response to speed changes (1.8±1 vs 1.1±0.3 for each speed increment p=0.226). 2D LVEDD slope decreased significantly with the HMII, but not with the HVAD (-0.17 vs -0.04, p=0.14). However, 3D surface analysis revealed that both devices reduced global LV volume similarly (82±32 vs 73±5 ml, p=0.4) but that changes LV shape differed between devices. LV shape changes were evident in every level of the heart in HMII patients but with HVAD, changes were noted only in the area of the apex. (figure). Both axial and continuous flow pumps unload the LV. However, changes in LV volume are manifest differently between HMII and HVAD. Those changes are hypothesized to be related to the intra-abdominal location of HMII compared with the intra-thoracic placement of HVAD. This study also indicates that ramp studies aimed at understanding ventricular unloading are best performed with geometry-independent parameters such as PCWP and LVV." @default.
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- W2073411400 date "2015-04-01" @default.
- W2073411400 modified "2023-09-27" @default.
- W2073411400 title "Similar Pressure and Volume Unloading With Different Geometrical Changes Between HVAD and HMII Detected During Hemodynamics 3D Echo Ramp Studies" @default.
- W2073411400 doi "https://doi.org/10.1016/j.healun.2015.01.628" @default.
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