Ultrasound-based estimation of remaining cardiac function in LVAD-supported ex vivo hearts
© 2020 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) andWiley Periodicals LLC..
Left ventricular assist devices (LVAD) provide cardiac support to patients with advanced heart failure. Methods that can directly measure remaining LV function following device implantation do not currently exist. Previous studies have shown that a combination of loading (LV pressure) and deformation (strain) measurements enables quantitation of myocardial work. We investigated the use of ultrasound (US) strain imaging and pressure-strain loop analysis in LVAD-supported hearts under different hemodynamic and pump unloading conditions, with the aim of determining LV function with and without LVAD support. Ex vivo porcine hearts (n = 4) were implanted with LVADs and attached to a mock circulatory loop. Measurements were performed at hemodynamically defined "heart conditions" as the hearts deteriorated from baseline. Hemodynamic (including LV pressure) and radio-frequency US data were acquired during a pump-ramp protocol at speeds from 0 (with no pump outflow) to 10 000 revolutions per minute (rpm). Regional circumferential (εcirc ) and radial (εrad ) strains were estimated over each heart cycle. Regional ventricular dyssynchrony was quantitated through time-to-peak strain. Mean change in LV pulse pressure and εcirc between 0 and 10 krpm were -21.8 mm Hg and -7.24% in the first condition; in the final condition -46.8 mm Hg and -19.2%, respectively. εrad was not indicative of changes in pump speed or heart condition. Pressure-strain loops showed a degradation in the LV function and an increased influence of LV unloading: loop area reduced by 90% between 0 krpm in the first heart condition and 10 krpm in the last condition. High pump speeds and degraded condition led to increased dyssynchrony between the septal and lateral LV walls. Functional measurement of the LV while undergoing LVAD support is possible by using US strain imaging and pressure-strain loops. This can provide important information about remaining pump function. Use of novel LV pressure estimation or measurement techniques would be required for any future use in LVAD patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
|---|---|
| Enthalten in: |
Artificial organs - 44(2020), 8 vom: 23. Aug., Seite E326-E336 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Fixsen, Louis S [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Echocardiography |
|---|
| Anmerkungen: |
Date Completed 02.06.2021 Date Revised 02.06.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/aor.13693 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM308283902 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM308283902 | ||
| 003 | DE-627 | ||
| 005 | 20231225131415.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/aor.13693 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1027.xml |
| 035 | |a (DE-627)NLM308283902 | ||
| 035 | |a (NLM)32242944 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Fixsen, Louis S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Ultrasound-based estimation of remaining cardiac function in LVAD-supported ex vivo hearts |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.06.2021 | ||
| 500 | |a Date Revised 02.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) andWiley Periodicals LLC. | ||
| 520 | |a Left ventricular assist devices (LVAD) provide cardiac support to patients with advanced heart failure. Methods that can directly measure remaining LV function following device implantation do not currently exist. Previous studies have shown that a combination of loading (LV pressure) and deformation (strain) measurements enables quantitation of myocardial work. We investigated the use of ultrasound (US) strain imaging and pressure-strain loop analysis in LVAD-supported hearts under different hemodynamic and pump unloading conditions, with the aim of determining LV function with and without LVAD support. Ex vivo porcine hearts (n = 4) were implanted with LVADs and attached to a mock circulatory loop. Measurements were performed at hemodynamically defined "heart conditions" as the hearts deteriorated from baseline. Hemodynamic (including LV pressure) and radio-frequency US data were acquired during a pump-ramp protocol at speeds from 0 (with no pump outflow) to 10 000 revolutions per minute (rpm). Regional circumferential (εcirc ) and radial (εrad ) strains were estimated over each heart cycle. Regional ventricular dyssynchrony was quantitated through time-to-peak strain. Mean change in LV pulse pressure and εcirc between 0 and 10 krpm were -21.8 mm Hg and -7.24% in the first condition; in the final condition -46.8 mm Hg and -19.2%, respectively. εrad was not indicative of changes in pump speed or heart condition. Pressure-strain loops showed a degradation in the LV function and an increased influence of LV unloading: loop area reduced by 90% between 0 krpm in the first heart condition and 10 krpm in the last condition. High pump speeds and degraded condition led to increased dyssynchrony between the septal and lateral LV walls. Functional measurement of the LV while undergoing LVAD support is possible by using US strain imaging and pressure-strain loops. This can provide important information about remaining pump function. Use of novel LV pressure estimation or measurement techniques would be required for any future use in LVAD patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a echocardiography | |
| 650 | 4 | |a ex vivo heart | |
| 650 | 4 | |a heart failure | |
| 650 | 4 | |a left ventricular assist devices | |
| 650 | 4 | |a pressure-strain loops | |
| 650 | 4 | |a speckle tracking | |
| 700 | 1 | |a Petterson, Niels J |e verfasserin |4 aut | |
| 700 | 1 | |a Houthuizen, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Rutten, Marcel C M |e verfasserin |4 aut | |
| 700 | 1 | |a van de Vosse, Frans N |e verfasserin |4 aut | |
| 700 | 1 | |a Lopata, Richard G P |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Artificial organs |d 1992 |g 44(2020), 8 vom: 23. Aug., Seite E326-E336 |w (DE-627)NLM000347590 |x 1525-1594 |7 nnns |
| 773 | 1 | 8 | |g volume:44 |g year:2020 |g number:8 |g day:23 |g month:08 |g pages:E326-E336 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/aor.13693 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 44 |j 2020 |e 8 |b 23 |c 08 |h E326-E336 | ||