Department of Artificial Organs, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan.
Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo , Tokyo, 113-8654, Japan.
Ann Biomed Eng. 2024 Feb;52(2):364-375. doi: 10.1007/s10439-023-03383-y. Epub 2023 Oct 18.
Asynchronous rotational-speed modulation of a continuous-flow left ventricular assist device (LVAD) can increase pulsatility; however, the feasibility of hemodynamic modification by asynchronous modulation of an LVAD has not been sufficiently verified. We evaluated the acute effect of an asynchronous-modulation mode under LVAD support and the accumulated effect of 6 consecutive hours of driving by the asynchronous-modulation mode on hemodynamics, including both ventricles, in a coronary microembolization-induced acute-myocardial injury sheep model. We evaluated 5-min LVAD-support hemodynamics, including biventricular parameters, by switching modes from constant-speed to asynchronous-modulation in the same animals ("acute-effect evaluation under LVAD support"). To determine the accumulated effect of a certain driving period, we evaluated hemodynamics including biventricular parameters after weaning from 6-hour (6 h) LVAD support by constant-speed or asynchronous-modulation mode ("6h-effect evaluation"). The acute-effect evaluation under LVAD support revealed that, compared to the constant-speed mode, the asynchronous-modulation mode increased vascular pulsatility but did not have significantly different effects on hemodynamics, including both ventricles. The 6 h-effect evaluation revealed that the hemodynamics did not differ significantly between the two groups except for some biventricular parameters which did not indicate negative effects of the asynchronous-modulation mode on both ventricles. The asynchronous-modulation mode could be feasible to increase vascular pulsatility without causing negative effects on hemodynamics including both ventricles. Compared to the constant-speed mode, the asynchronous-modulation mode increased pulsatility during LVAD support without negative effects on hemodynamics including both ventricles in the acute phase. Six hours of LVAD support with the asynchronous-modulation mode exerted no negative effects on hemodynamics, including both ventricles, after weaning from the LVAD.
异步转速调节的连续血流左心室辅助装置（LVAD）可以增加脉动性；然而，LVAD 的异步调节对血液动力学的改变的可行性尚未得到充分验证。我们评估了 LVAD 支持下异步调节模式的急性效应，以及在冠状动脉微栓塞诱导的急性心肌损伤绵羊模型中，连续 6 小时异步调节模式对血液动力学的累积效应，包括两个心室。我们通过在同一动物中从恒速切换到异步调节模式来评估 5 分钟的 LVAD 支持血液动力学，包括双心室参数（“LVAD 支持下的急性效应评估”）。为了确定一定驱动周期的累积效应，我们在通过恒速或异步调节模式脱离 6 小时（6 h）LVAD 支持后评估包括双心室参数的血液动力学（“6 h 效应评估”）。LVAD 支持下的急性效应评估表明，与恒速模式相比，异步调节模式增加了血管脉动性，但对包括双心室在内的血液动力学没有显著不同的影响。6 h 效应评估表明，两组之间的血液动力学没有显著差异，除了一些双心室参数没有表明异步调节模式对两个心室没有负面影响。异步调节模式可能增加血管脉动性而不会对包括双心室在内的血液动力学产生负面影响。与恒速模式相比，异步调节模式在 LVAD 支持期间增加了脉动性，而在急性阶段对包括双心室在内的血液动力学没有负面影响。脱离 LVAD 后，异步调节模式的 6 小时 LVAD 支持对包括双心室在内的血液动力学没有负面影响。
