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- W4387639230 abstract "Left ventricular assist device (LVAD) support offers remodelling potential in some patients. Our goal was to use non-invasively derived pressure-volume (PV) loops to understand the effect of demographic and device variables on serial changes in cardiac function under pump support.Thirty-two consecutive Medtronic HVAD patients (mean 55.9±12.3 years, 81.3% male) were prospectively recruited. Single-cycle ventricular pressure and volume were estimated using a validated algorithm. PV loops (n=77) and corresponding cardiac chamber dynamics were derived at predefined post-implant timepoints (1, 3, 6 months). Changes in PV loop parameters sustained across the 6-month period were characterised using mixed-effects modelling. The influence of demographic and device variables on the observed changes were assessed.Across a 6-month period, the mean ventricular function parameters remained stable. Significant predictors of monthly improvement of stroke work include: lower pump speeds (2400rpm vs 2500-2800rpm) [0.0.051mmHg/L/month (p=0.001)], high pulsatility index (>1.0 vs <1.0) [0.052mmHg/L/month (p=0.012)], and ischemic cardiomyopathy indication for LVAD implantation (vs non-ischemic) [0.0387mmHg/L/month (p=0.007)]. Various other cardiac chamber function parameters including cardiac power, peak systolic pressure and LV elastance also showed improvements in these cohorts.Factors associated with improvement in ventricular energetics and hemodynamics under LVAD support can be determined with non-invasive PV loops. Understanding the basis of increasing ventricular load to optimise myocardial remodelling may prove valuable in selecting eligible recovery candidates." @default.
- W4387639230 created "2023-10-15" @default.
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- W4387639230 date "2023-10-01" @default.
- W4387639230 modified "2023-10-18" @default.
- W4387639230 title "Longitudinal Analysis Left Ventricular Chamber Responses Under Durable LVAD Support" @default.
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- W4387639230 doi "https://doi.org/10.1016/j.healun.2023.10.004" @default.
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