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植入式连续流左心室辅助装置(EVAHEART)的新型心电图同步转速变化系统对溶血性能的影响。

Influence of a novel electrocardiogram-synchronized rotational-speed-change system of an implantable continuous-flow left ventricular assist device (EVAHEART) on hemolytic performance.

作者信息

Kishimoto Satoru, Date Kazuma, Arakawa Mamoru, Takewa Yoshiaki, Nishimura Takashi, Tsukiya Tomonori, Mizuno Toshihide, Katagiri Nobumasa, Kakuta Yukihide, Ogawa Daisuke, Nishimura Motonobu, Tatsumi Eisuke

机构信息

Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai Suita, Osaka, 565-8565, Japan,

出版信息

J Artif Organs. 2014 Dec;17(4):373-7. doi: 10.1007/s10047-014-0787-8. Epub 2014 Sep 2.

DOI:10.1007/s10047-014-0787-8
PMID:25178643
Abstract

We developed a novel controller for a continuous-flow left ventricular assist device (EVAHEART) that can change the pump's rotational speed (RS) in synchronization with a patient's myocardial electrocardiogram (ECG) with the aim of facilitating cardiac recovery. We previously presented various applications of this system in animal models, but there remained a concern that the repeated acceleration and deceleration of the impeller may induce additional hemolysis. In this study, we evaluated the blood trauma and motor power consumption induced by our system in a mock circulation. We evaluated our system with a 60-bpm pulse frequency and a variance between the high and low RSs of 500 rpm (EVA-P; n = 4). The continuous modes of EVAHEART (EVA-C; n = 4) and ROTAFLOW (n = 4) were used as controls. The pumps were examined at a mean flow rate of 5.0 ± 0.2 L/min against a mean pressure head of 100 ± 3 mmHg for a 4-h period. As a result, the normalized indexes of the hemolysis levels of EVA-P and EVA-C were 0.0023 ± 0.0019 and 0.0023 ± 0.0025, respectively, and their difference was not significant. The estimated mean motor power consumptions of EVA-C and EVA-P were 6.24 ± 0.33 and 7.19 ± 0.93 W, respectively. When a novel ECG-synchronized RS-change system was applied to EVAHEART, the periodic RS change with a 500-rpm RS variance did not affect the hemolysis at a 60-bpm pulse frequency.

摘要

我们开发了一种用于连续流左心室辅助装置(EVAHEART)的新型控制器,该控制器可与患者的心肌心电图(ECG)同步改变泵的转速(RS),以促进心脏恢复。我们之前在动物模型中展示了该系统的各种应用,但仍有人担心叶轮的反复加速和减速可能会导致额外的溶血。在本研究中,我们在模拟循环中评估了该系统引起的血液损伤和电机功耗。我们以60次/分钟的脉冲频率和500转/分钟的高低RS差值评估了我们的系统(EVA-P;n = 4)。EVAHEART的连续模式(EVA-C;n = 4)和ROTAFLOW(n = 4)用作对照。在平均流速为5.0±0.2升/分钟、平均压头为100±3毫米汞柱的条件下对泵进行了4小时的检查。结果,EVA-P和EVA-C的溶血水平归一化指标分别为0.0023±0.0019和0.0023±0.0025,两者差异不显著。EVA-C和EVA-P的估计平均电机功耗分别为6.24±0.33瓦和7.19±0.93瓦。当将一种新型的心电图同步RS改变系统应用于EVAHEART时,在60次/分钟的脉冲频率下,500转/分钟RS差值的周期性RS变化不会影响溶血。

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本文引用的文献

1
Alternation of left ventricular load by a continuous-flow left ventricular assist device with a native heart load control system in a chronic heart failure model.采用具有原生心脏负荷控制系统的连续流左心室辅助装置改变慢性心力衰竭模型中的左心室负荷。
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2
Development of a novel drive mode to prevent aortic insufficiency during continuous-flow LVAD support by synchronizing rotational speed with heartbeat.通过使转速与心跳同步来开发一种新型驱动模式,以在连续流左心室辅助装置支持期间预防主动脉瓣关闭不全。
J Artif Organs. 2013 Jun;16(2):129-37. doi: 10.1007/s10047-012-0685-x. Epub 2013 Jan 23.
3
使用天然心脏负荷控制系统,通过增加旋转式左心室辅助装置(LVAD)的转速变化来改变搏动性。
J Artif Organs. 2016 Dec;19(4):315-321. doi: 10.1007/s10047-016-0906-9. Epub 2016 May 14.
Change of coronary flow by continuous-flow left ventricular assist device with cardiac beat synchronizing system (native heart load control system) in acute ischemic heart failure model.
带心脏搏动同步系统(原生心脏负荷控制系统)的连续血流左心室辅助装置对急性缺血性心力衰竭模型中心脏冠脉血流的改变。
Circ J. 2013;77(4):995-1000. doi: 10.1253/circj.cj-12-0676. Epub 2012 Dec 27.
4
Blood trauma testing of CentriMag and RotaFlow centrifugal flow devices: a pilot study.CentriMag 和 RotaFlow 离心流装置的血液创伤检测:一项初步研究。
Artif Organs. 2012 Aug;36(8):677-82. doi: 10.1111/j.1525-1594.2012.01514.x.
5
Creating an ideal "off-test mode" for rotary left ventricular assist devices: establishing a safe and appropriate weaning protocol after myocardial recovery.为旋转左心室辅助设备创建理想的“脱机模式”:在心肌恢复后建立安全且合适的脱机方案。
J Thorac Cardiovasc Surg. 2012 May;143(5):1176-82. doi: 10.1016/j.jtcvs.2011.07.065. Epub 2011 Dec 3.
6
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J Artif Organs. 2012 Jun;15(2):128-33. doi: 10.1007/s10047-011-0615-3. Epub 2011 Nov 12.
7
A novel counterpulsation mode of rotary left ventricular assist devices can enhance myocardial perfusion.一种新型的旋转式左心室辅助装置反搏模式可增强心肌灌注。
J Artif Organs. 2011 Sep;14(3):185-91. doi: 10.1007/s10047-011-0573-9. Epub 2011 May 28.
8
Electrocardiogram-synchronized rotational speed change mode in rotary pumps could improve pulsatility.旋转泵中的心电图同步转速变化模式可以改善脉动性。
Artif Organs. 2011 Oct;35(10):941-7. doi: 10.1111/j.1525-1594.2011.01205.x. Epub 2011 May 25.
9
A novel counterpulse drive mode of continuous-flow left ventricular assist devices can minimize intracircuit backward flow during pump weaning.连续流左心室辅助装置的一种新型反搏驱动模式可在撤泵期间将回路内的反向血流降至最低。
J Artif Organs. 2011 Mar;14(1):74-9. doi: 10.1007/s10047-010-0544-6. Epub 2011 Jan 18.
10
EVAHEART: an implantable centrifugal blood pump for long-term circulatory support.EVAHEART:一种用于长期循环支持的植入式离心血泵。
Jpn J Thorac Cardiovasc Surg. 2002 Nov;50(11):461-5. doi: 10.1007/BF02919636.