The influence of left ventricle assist device and ventilatory support on energy-related cardiovascular variables.
The influence of left ventricle assist device and ventilatory support on energy-related cardiovascular variables.
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DOI：
10.1016/s1350-4533(98)00008-3
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发表时间：
1998-03-01
影响因子：
2.2
通讯作者：
Clemente, F
中科院分区：
文献类型：
--
作者：
De Lazzari, C;Darowski, M;Clemente, F
使用左心室辅助装置（LVAD）辅助心力衰竭患者康复的主要目的之一是减少左自然心室的外功（EW）。机械通气支持的同时存在会影响该变量的值。我们的计算机模拟的目的是追踪LVAD在有通气支持的情况下对EW、心脏机械效率（CME）和压力容积面积（PVA）的影响。复制了心脏的病理情况。外周全身动脉阻力（Ras）也被改变以模拟生理和病理状态。通过改变平均胸压水平来介绍机械通气的影响。通过这种方法，我们能够预测在通气（机械）和心血管（LVAD）支持期间双心室EW、CME和PVA的变化。我们的模拟表明，胸正压似乎会影响与能量相关的心血管变量，在评估LVAD有效性时应考虑到这一点。全身外周阻力的病理改变对左心室EW、CME和PVA有相当大的影响。另一方面，右心室的能量相关参数并不特别受全身外周阻力变化的影响。(c) 1998年。Elsevier Science Ltd.出版。版权所有。
One of the main purposes in using Left Ventricle Assist Devices (LVAD) to assist recovery in patients with heart failure, is to reduce the external work (EW) of the left natural ventricle. The simultaneous presence of mechanical ventilatory support can affect the value of this variable. The aim of our computer simulation was to trace the influence of LVAD on EW, cardiac mechanical efficiency (CME) and pressure volume area (PVA) in the presence of ventilatory support. Pathological conditions of the heart were reproduced. Peripheral systemic arterial resistance (Ras) was also changed to model physiological and pathological states. The influence of mechanical ventilation was introduced by changing levels of mean thoracic pressure. In this way we were able to predict changes of EW, CME and PVA in both ventricles, during ventilatory (mechanical) and cardiovascular (LVAD) support. Our simulation showed that positive thoracic pressure seems re affect the energy-related cardiovascular variables and should be taken into account during the assessment of LVAD effectiveness. Pathological changes of systemic peripheral resistance have a considerable effect on EW, CME and PVA of left ventricle. On the other hand energy-related parameters of the right ventricle are not especially affected by changes in systemic peripheral resistance. (C) 1998 IPEM. Published by Elsevier Science Ltd. All rights reserved.