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HeartMate 3 Snoopy:在超声心动图速度 ramp 试验和瓦尔萨尔瓦动作期间使用全磁悬浮血泵对患者进行无创心血管诊断。

HeartMate 3 Snoopy: Noninvasive cardiovascular diagnosis of patients with fully magnetically levitated blood pumps during echocardiographic speed ramp tests and Valsalva maneuvers.

机构信息

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.

Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.

出版信息

J Heart Lung Transplant. 2024 Feb;43(2):251-260. doi: 10.1016/j.healun.2023.09.011. Epub 2023 Sep 26.

Abstract

PURPOSE

The HeartMate 3 (HM3) left ventricular assist device (LVAD) has demonstrated excellent clinical outcomes; however, pump speed optimization is challenging with the available HM3 monitoring. Therefore, this study reports on clinical HM3 parameters collected with a noninvasive HM3 monitoring system (HM3 Snoopy) during echocardiographic speed ramp tests and Valsalva maneuvers.

METHODS

In this prospective, single-center study, the HM3 data communication between the controller and pump was recorded with a novel data acquisition system. Twelve pump parameters sampled every second (1 Hz) and clinical assessments (echocardiography, electrocardiogram (ECG), and blood pressure measurement) during speed ramp tests were analyzed using Pearson's correlation (r, median [IQR]). The cause for the occurrence of pulsatility index (PI)-events during ramp speed tests and valsalva maneuvers was investigated.

RESULTS

In 24 patients (age: 58.9 ± 8.8 years, body mass index: 28.1 ± 5.1 kg/m, female: 20.8%), 35 speed ramp tests were performed with speed changes in the range of ±1000 rpm from a baseline speed of 5443 ± 244 rpm. Eight HM3 pump parameters from estimated flow, motor current, and LVAD speed together with blood pressure showed positive collinearities (r = 0.9 [0.1]). Negative collinearities were observed for pump flow pulsatility, pulsatility index, rotor noise, and left ventricular diameters (r = -0.8 [0.1]), whereas rotor displacement and heartrate showed absence of collinearities (r = -0.1 [0.08]).

CONCLUSIONS

In this study, the HM3 Snoopy was successfully used to acquire more parameters from the HM3 at a higher sampling rate. Analysis of HM3 per-second data provide additional clinical diagnostic information on heart-pump interactions and cause of PI-events.

摘要

目的

HeartMate 3(HM3)左心室辅助装置(LVAD)已显示出出色的临床结果;然而,可用的 HM3 监测对泵速优化提出了挑战。因此,本研究报告了在超声心动图速度斜坡试验和瓦尔萨尔瓦动作期间使用非侵入性 HM3 监测系统(HM3 Snoopy)收集的临床 HM3 参数。

方法

在这项前瞻性、单中心研究中,使用新型数据采集系统记录了控制器和泵之间的 HM3 数据通信。分析了速度斜坡试验期间每秒钟(1Hz)采样 12 个泵参数和临床评估(超声心动图、心电图(ECG)和血压测量),并使用 Pearson 相关系数(r,中位数[IQR])进行分析。调查了在速度斜坡试验和瓦尔萨尔瓦动作期间发生脉动指数(PI)事件的原因。

结果

在 24 名患者(年龄:58.9±8.8 岁,体重指数:28.1±5.1kg/m,女性:20.8%)中,进行了 35 次速度斜坡试验,速度变化范围为从基线速度 5443±244rpm 变化±1000rpm。从估计流量、电机电流和 LVAD 速度以及血压中获得的 8 个 HM3 泵参数显示出正的共线性(r=0.9[0.1])。泵流量脉动性、脉动指数、转子噪声和左心室直径观察到负共线性(r=-0.8[0.1]),而转子位移和心率显示不存在共线性(r=-0.1[0.08])。

结论

在这项研究中,HM3 Snoopy 成功地用于以更高的采样率从 HM3 中获取更多参数。对 HM3 每秒数据的分析提供了有关心脏-泵相互作用和 PI 事件原因的额外临床诊断信息。

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