Quantification of interventricular dyssynchrony during continuous-flow left ventricular assist device support.
Quantification of interventricular dyssynchrony during continuous-flow left ventricular assist device support.
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连续流左心室辅助装置支持期间心室不同步的量化。
DOI：
10.1007/s10047-019-01109-3
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Tatsumi E
中科院分区：
文献类型：
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作者：
Shimamura J;Nishimura T;Mizuno T;Takewa Y;Tsukiya T;Inatomi A;Ando M;Umeki A;Naito N;Ono M;Tatsumi E
在连续流左心室辅助装置(CF-LVAD)支持下，由于左心室收缩缩短，左、右室(LV)之间的心动周期和左、右室容量变化不同步。本研究的目的是量化基于不同的CF-LVAD支持条件的室间不同步性，并评估其与LV卸载的关系。在本研究中，我们评估了7只山羊(体重44.5 ± 6.5 kg)和正常心脏。在全身麻醉下植入离心式左冠状动脉前降支。将导尿管同时插入左、右室以评估容量信号。我们将室间不同步定义为与右室容量(RVV)相反的左心室容量变化(增加或减少)的信号(即(dLVV/dt) × (DRVV/dt) <； 0)。室间不同步持续时间(DYS)是指心脏在一个心动周期内处于不同步状态的时间百分比。正常心脏、夹心组和转流率分别为50%、75%和100%的心脏平均DY分别为5.6 ± 1.6%、8.7 ± 2.4%、8.6 ± 2.8%、15.1 ± 5.1%和25.6 ± 8.0%。此外，DYS还与LV负荷引起的LV每搏量减少的程度有关。这些发现可能有助于了解CF-LVAD支持过程中的室间相互作用和生理学。对右心功能和心力衰竭模型的影响有待进一步研究。
Under continuous-flow left ventricular assist device (CF-LVAD) support, the ventricular volume change and cardiac cycle between the left ventricle (LV) and right ventricle (RV) become dyssynchronous due to the shortening of the LV systole. The purpose of this study was to quantify interventricular dyssynchrony based on different CF-LVAD support conditions and assess its relationship with LV unloading. In this study, we evaluated seven goats (body weight 44.5 ± 6.5 kg) with normal hearts. A centrifugal LVAD was implanted under general anesthesia. We inserted the conductance catheters into the left ventricle (LV) and right ventricle (RV) to assess the volume signal simultaneously. We defined the interventricular dyssynchrony as a signal (increase or decrease) of LV volume (LVV) change opposite to that of RV volume (RVV) (i.e., (dLVV/dt) × (dRVV/dt) < 0). The duration of interventricular dyssynchrony (DYS) was reported as the percentage of time that a heart was in a dyssynchronous state within a cardiac cycle. The mean DYS of normal hearts, hearts with LVAD clamp and hearts supported by LVADs with a bypass rate of 50%, 75% and 100% were 5.6 ± 1.6%, 8.7 ± 2.4%, 8.6 ± 2.8%, 15.1 ± 5.1%, and 25.6 ± 8.0%, respectively. Furthermore, the DYS was found to be associated with the degree of LV stroke volume reduction caused by LV unloading. These findings may be useful for understanding interventricular interactions and physiology during CF-LVAD support. Influences on the right ventricular function and heart failure models warrant further study.