Shifting the pulsatility by increasing the change in rotational speed for a rotary LVAD using a native heart load control system.
Shifting the pulsatility by increasing the change in rotational speed for a rotary LVAD using a native heart load control system.
复制标题
使用原生心脏负荷控制系统，通过增加旋转 LVAD 的转速变化来改变脉动。
DOI：
10.1007/s10047-016-0906-9
复制
发表时间：
2016
影响因子：
1.3
通讯作者：
Tatsumi E.
中科院分区：
文献类型：
--
作者：
Date K;Nishimura T;Takewa Y;Kishimoto S;Arakawa M;Umeki A;Ando M;Mizuno T;Tsukiya T;Ono M;Tatsumi E.
我们之前已经开发了一种用于连续血流左心室辅助装置（LVAD）的原生心脏负荷控制系统（(EVAHEART®；Sun Medical)），并证明了与心脏周期同步的转速（RS）可以改变全身麻醉下的脉搏和左心室（LV）负荷。在这项研究中，我们评估了不同程度的RS增加对慢性清醒期脉搏和左室负荷的影响。我们将EVAHEART经左开胸植入7只正常山羊（59.3±4.6 kg）。植入两周后，我们检查了共脉冲模式（收缩期RS增加）和反脉冲模式（舒张期RS增加）的影响，以及两种模式下RS从250转到500转和750转对搏动和低压负荷的影响。使用脉压和平均dP/dt max来评估脉搏性。左室负荷通过脑卒中功和左室舒张末期容积来评估。在共脉冲模式下，随着RS变化的增加，脉搏值也随之增加。相反，在反脉冲模式下，这些值随着RS变化的增加而减小。与反脉冲模式相比，共脉冲模式下低压负荷显著增加，但两种模式下三个水平的RS增加均无显著差异。用我们新开发的系统不同程度地增加RS可以促进搏动。然而，它似乎对正常心脏的低电压负荷几乎没有影响。
We have previously developed a native heart load control system for a continuous-flow left ventricular assist device (LVAD) ((EVAHEART®; Sun Medical) and demonstrated that the rotational speed (RS) in synchronization with the cardiac cycle can alter pulsatility and left ventricular (LV) load under general anesthesia. In this study, we assessed the effects of different levels of increase in RS on pulsatility and LV load in the chronic awake phase. We implanted the EVAHEART via left thoracotomy in 7 normal goats (59.3 ± 4.6 kg). Two weeks after implantation, we examined the effects of co-pulse mode (increased RS in the systolic phase) and counter-pulse mode (increased RS in the diastolic phase), as well as shifting the change in RS from 250 to 500 rpm, and 750 rpm in both modes on pulsatility and LV load. Pulsatility was assessed using pulse pressure and mean dP/dt max of aortic pressure. LV load was assessed using stroke work and left ventricle end-diastolic volume determined from LV pressure–volume loops. In the co-pulse mode, pulsatility values increased as the change in RS increased. By contrast, in the counter-pulse mode, these values decreased as the change in RS increased. LV load increased significantly in the co-pulse mode compared with the counter-pulse mode, but there were no significant differences among the three levels of RS increase in either mode. Increasing RS to varying degrees with our newly developed system could contribute to pulsatility. However, it appeared to have little effect on LV load in normal hearts.