Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
Department of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Ann Biomed Eng. 2023 Dec;51(12):2824-2836. doi: 10.1007/s10439-023-03345-4. Epub 2023 Sep 4.
Durable mechanical circulatory support in the form of left ventricular (LV) assist device (LVAD) therapy is increasingly considered in the context of the recovery of native cardiac function. Progressive improvement in LV function may facilitate LVAD explantation and a resultant reduction in device-related risk. However, ascertaining LV recovery remains a challenge. In this study, we investigated the use of trans-aortic valvular flow rate and trans-LVAD flow rate to assess native LV systolic function using a well-established lumped parameter model of the mechanically assisted LV with pre-existing systolic dysfunction. Trans-aortic valvular ejection fraction (TAVEF) was specifically found to characterize the preload-independent contractility of the LV. It demonstrated excellent sensitivity to simulated pharmacodynamic stress tests and volume infusion tests. TAVEF may prove to be useful in the ascertainment of LV recovery in LVAD-supported LVs with pre-existing LV systolic dysfunction.
以左心室（LV）辅助装置（LVAD）治疗为形式的耐用机械循环支持，在恢复原生心脏功能的背景下越来越受到关注。LV 功能的逐渐改善可能有助于 LVAD 去除，并相应降低与设备相关的风险。然而，确定 LV 恢复仍然是一个挑战。在这项研究中，我们使用经主动脉瓣口流量和经 LVAD 流量来评估使用机械辅助 LV 的成熟集总参数模型评估原发性 LV 收缩功能，该模型预先存在收缩功能障碍。经主动脉瓣口射血分数（TAVEF）被特别发现可用于描述 LV 的前负荷独立收缩性。它对模拟药物动力学压力测试和容量输注测试具有出色的敏感性。TAVEF 可能有助于确定具有预先存在 LV 收缩功能障碍的 LVAD 支持的 LV 中的 LV 恢复。
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