Effects of acute pump speed changes on cerebral hemodynamics in patients with an implantable continuous-flow left ventricular assist devices

Title:

Effects of acute pump speed changes on cerebral hemodynamics in patients with an implantable continuous-flow left ventricular assist devices

Creator:

Konarik, Miroslav, Sramko, Marek, Dorazilova, Zora, Blaha, Martin, Netuka, Ivan, Ivak, Peter, Maly, Jiri, and Szarszoi, Ondrej

Identifier:

https://cdk.lib.cas.cz/client/handle/uuid:51bff206-8a28-452b-8807-fd0d3eeee541
uuid:51bff206-8a28-452b-8807-fd0d3eeee541
doi:10.33549/physiolres.934738

Subject:

LVAD, continuous flow, plethysmography, and cerebral autoregulation

Type:

model:article and TEXT

Format:

počítač and online zdroj

Description:

Mechanical circulatory support (MCS) with an implantable left ventricular assist device (LVAD) is an established therapeutic option for advanced heart failure. Most of the currently used LVADs generate a continuous stream of blood that decreases arterial pulse pressure. This study investigated whether a change of the pulse pressure during different pump speed settings would affect cerebral autoregulation and thereby affect cerebral blood flow (CBF). The study included 21 haemodynamically stable outpatients with a continuous-flow LVAD (HeartMate II, Abbott, USA) implanted a median of 6 months before the study (interquartile range 3 to 14 months). Arterial blood pressure (measured by finger plethysmography) was recorded simultaneously with CBF (measured by transcranial Doppler ultrasound) during baseline pump speed (8900 rpm [IQR 8800; 9200]) and during minimum and maximum tolerated pump speeds (8000 rpm [IQR 8000; 8200] and 9800 rpm [IQR 9800; 10 000]). An increase in LVAD pump speed by 800 rpm [IQR 800; 1000] from the baseline lead to a significant decrease in arterial pulse pressure and cerebral blood flow pulsatility (relative change −24 % and −32 %, both p < 0.01), but it did not affect mean arterial pressure and mean CBF velocity (relative change 1 % and −1.7 %, p=0.1 and 0.7). In stable patients with a continuous-flow LVAD, changes of pump speed settings within a clinically used range did not impair static cerebral autoregulation and cerebral blood flow.

Language:

English

Rights:

http://creativecommons.org/licenses/by-nc-sa/4.0/
policy:public

Coverage:

831-839

Source:

Physiological research | 2021 Volume:70 | Number:6

Harvested from:

CDK

Metadata only:

false