Impact of continuous-flow mechanical circulatory support on cerebrospinal fluid motility
© 2023 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC..
BACKGROUND: Mechanical circulatory support (MCS), including ventricular assist devices (VADs), have emerged as promising therapeutic alternatives for end-stage congestive heart failure (CHF). The latest generation of these devices are continuous flow (CF) blood pumps. While there have been demonstrated benefits to patient outcomes due to CF-MCS, there continue to be significant clinical challenges. Research to-date has concentrated on mitigating thromboembolic risk (stroke), while the downstream impact of CF-MCS on the cerebrospinal fluid (CSF) flow has not been well investigated. Disturbances in the CSF pressure and flow patterns are known to be associated with neurologic impairment and diseased states. Thus, here we seek to develop an understanding of the pathophysiologic consequences of CF-MCS on CSF dynamics.
METHODS: We built and validated a computational framework using lumped parameter modeling of cardiovascular, cerebrovascular physics, CSF dynamics, and autoregulation. A sensitivity analysis was performed to confirm robustness of the modeling framework. Then, we characterized the impact of CF-MCS on the CSF and investigated cardiovascular conditions of healthy and end-stage heart failure.
RESULTS: Modeling results demonstrated appropriate hemodynamics and indicated that CSF pressure depends on blood flow pulsatility more than CSF flow. An acute equilibrium between CSF production and absorption was observed in the CF-MCS case, characterized by CSF pressure remaining elevated, and CSF flow rates remaining below healthy, but higher than CHF states.
CONCLUSION: This research has advanced our understanding of the impact of CF-MCS on CSF dynamics and cerebral hemodynamics.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
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| Enthalten in: |
Artificial organs - 47(2023), 10 vom: 14. Okt., Seite 1567-1580 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rose, William [VerfasserIn] |
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| Links: |
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| Themen: |
Blood pump |
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| Anmerkungen: |
Date Completed 30.10.2023 Date Revised 30.10.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/aor.14624 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361014074 |
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| 500 | |a Date Revised 30.10.2023 | ||
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND: Mechanical circulatory support (MCS), including ventricular assist devices (VADs), have emerged as promising therapeutic alternatives for end-stage congestive heart failure (CHF). The latest generation of these devices are continuous flow (CF) blood pumps. While there have been demonstrated benefits to patient outcomes due to CF-MCS, there continue to be significant clinical challenges. Research to-date has concentrated on mitigating thromboembolic risk (stroke), while the downstream impact of CF-MCS on the cerebrospinal fluid (CSF) flow has not been well investigated. Disturbances in the CSF pressure and flow patterns are known to be associated with neurologic impairment and diseased states. Thus, here we seek to develop an understanding of the pathophysiologic consequences of CF-MCS on CSF dynamics | ||
| 520 | |a METHODS: We built and validated a computational framework using lumped parameter modeling of cardiovascular, cerebrovascular physics, CSF dynamics, and autoregulation. A sensitivity analysis was performed to confirm robustness of the modeling framework. Then, we characterized the impact of CF-MCS on the CSF and investigated cardiovascular conditions of healthy and end-stage heart failure | ||
| 520 | |a RESULTS: Modeling results demonstrated appropriate hemodynamics and indicated that CSF pressure depends on blood flow pulsatility more than CSF flow. An acute equilibrium between CSF production and absorption was observed in the CF-MCS case, characterized by CSF pressure remaining elevated, and CSF flow rates remaining below healthy, but higher than CHF states | ||
| 520 | |a CONCLUSION: This research has advanced our understanding of the impact of CF-MCS on CSF dynamics and cerebral hemodynamics | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a blood pump | |
| 650 | 4 | |a cerebral hemodynamics | |
| 650 | 4 | |a cerebrospinal fluid | |
| 650 | 4 | |a cerebrospinal fluid motility | |
| 650 | 4 | |a mechanical circulatory support | |
| 650 | 4 | |a ventricular assist device | |
| 700 | 1 | |a Throckmorton, Amy L |e verfasserin |4 aut | |
| 700 | 1 | |a Heintzelman, Briana |e verfasserin |4 aut | |
| 700 | 1 | |a Tchantchaleishvili, Vakhtang |e verfasserin |4 aut | |
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