The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články, pozorovací studie, práce podpořená grantem
PubMed
34090978
DOI
10.1016/j.cjca.2021.05.013
PII: S0828-282X(21)00289-0
Knihovny.cz E-zdroje
- MeSH
- arterie patofyziologie MeSH
- časové faktory MeSH
- cévní endotel patofyziologie MeSH
- cévní rezistence fyziologie MeSH
- funkce levé komory srdeční fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- podpůrné srdeční systémy * MeSH
- prospektivní studie MeSH
- srdeční komory patofyziologie MeSH
- srdeční selhání patofyziologie terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: Implantation of left-ventricular assist systems (LVASs) has become the standard of care for advanced heart failure (HF). The absence of pulsatility in previous devices contributes to vascular and endothelial dysfunction related to atherosclerotic or vascular complications. We hypothesized that the artificial pulsatility provided by the HeartMate 3 (HM3) (Abbott, Chicago, IL) LVAS would exert a favourable effect on the vasculature. METHODS: In 32 patients implanted with HM3 (5 female patients, mean age 55 ± 13.6 years), the reactive hyperemia index (RHI) and peripheral augmentation index (AI), markers of endothelial function and arterial stiffness, were measured with an EndoPAT2000 before and in the third and sixth month after implantation. RHI and AI data from 30 HeartMate II (HM II) (Abbott) recipients in the third and sixth month after implantation, from 15 patients with advanced HF without LVASs and from 13 healthy volunteers were also analyzed. RESULTS: In HM3 recipients, the mean RHI significantly decreased at 3 and 6 months after implantation. The RHI was substantially lower at baseline than that of healthy or the HF reference group. Increasing AI values, indicating worsening arterial stiffness, were also observed. Similar trends were observed in HM II recipients between the third and sixth months but with higher absolute values of RHI and AI. CONCLUSIONS: We detected impaired vascular function in HM3 patients and provided additional evidence on the negative effect of low pulsatility on vascular function after LVAS implantation. The results suggest that the artificial pulsatility of the HM3 does not avert the progression of endothelial dysfunction.
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Physiology 3rd Faculty of Medicine Charles University Prague Czech Republic
Medical Statistics Unit Institute for Clinical and Experimental Medicine Prague Czech Republic
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