The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices
| Autor: | Miloš Kubánek, Z. Tucanova, Jan Pitha, Ondrej Szarszoi, Ivan Netuka, Vera Lanska, Peter Wohlfahrt, Peter Ivak, Sarka Novakova, Miroslav Konarik |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Heart Ventricles 030204 cardiovascular system & hematology Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient 030212 general & internal medicine Prospective Studies Endothelial dysfunction Reactive hyperemia Heart Failure Heartmate ii business.industry Continuous flow Arteries Middle Aged medicine.disease Peripheral Heart failure Arterial stiffness Cardiology Female Vascular Resistance Endothelium Vascular Heart-Assist Devices Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Canadian journal of cardiology. 37(10) |
| ISSN: | 1916-7075 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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