Interventricular dyssynchrony during continuous-flow left ventricular assist device support: observation using the conductance method.
Interventricular dyssynchrony during continuous-flow left ventricular assist device support: observation using the conductance method.
复制标题
连续流左心室辅助装置支持期间的心室不同步：使用电导法观察。
DOI：
10.1007/s10047-019-01115-5
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发表时间：
2019
期刊：
影响因子：
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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;Katagiri N;Ando M;Umeki A;Akiyama D;Arakawa M;Ono M;Tatsumi E.
本研究的目的是用电导法观察和阐明连续流左心室辅助装置（CF-LVAD）支持所引起的室间性血流动力学障碍。在CF-LVAD支持期间，左心室（LV）的收缩期变得短于右心室（RV）的收缩期。因此，心动周期期间的收缩期和舒张期的定时在LV和RV之间不同步。在这项研究中，我们使用成年山羊（n= 5，体重44.5 ± 2.9 kg）在正常心脏模型中评估了这种现象。在全身麻醉下植入离心LVAD。我们将传导导管插入右心室和左心室，以同时获得两个心室的压力-容积关系。我们将不同步状态定义为左心室容积变化的符号（正或负）与右心室容积变化的符号相反。LVAD停泵组和LVAD全转流组分别有5.6 ± 0.65%和25.3 ± 3.3%的心脏出现心动周期不同步（p< 0.05）。据我们所知，这是第一个实验报告澄清在CF-LVAD支持使用电导法室间不同步。在各种支持条件下，这种现象的量化和对右心室功能的影响评估将在未来的研究中进行研究。
The purpose of this study was to observe and clarify the interventricular dysscynchrony caused by continuous-flow left ventricular assist device (CF-LVAD) support using the conductance method. During CF-LVAD support, the systolic phase of the left ventricle (LV) becomes shorter than that of the right ventricle (RV). Accordingly, timing of the systole and diastole during the cardiac cycle is not synchronous between the LV and RV. In this study, we evaluated this phenomenon in a normal heart model using the adult goat (n= 5, body weight 44.5 ± 2.9 kg). A centrifugal LVAD was implanted under general anesthesia. We inserted the conductance catheter into the RV and LV to obtain the pressure–volume relationship of the two ventricles simultaneously. We defined the dyssynchronous status as the sign (plus or minus) of the LV volume-change opposite to that of RV volume-change. Dyssynchronous phase of the cardiac cycle was observed in 5.6 ± 0.65% of hearts under LVAD pump-off and 25.3 ± 3.3% under LVAD full bypass, respectively (p< 0.05). To the best of our knowledge, this is the first experimental report clarifying interventricular dyssynchrony during CF-LVAD support using the conductance method. Quantification of this phenomenon under various support conditions and assessment of influences on the right ventricular function will be studied in future studies.