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Quantification of interventricular dyssynchrony during continuous-flow left ventricular assist device support

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  • Artificial Heart (Basic)
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Abstract

Under continuous-flow left ventricular assist device (CF-LVAD) support, the ventricular volume change and cardiac cycle between the left ventricle (LV) and right ventricle (RV) become dyssynchronous due to the shortening of the LV systole. The purpose of this study was to quantify interventricular dyssynchrony based on different CF-LVAD support conditions and assess its relationship with LV unloading. In this study, we evaluated seven goats (body weight 44.5 ± 6.5 kg) with normal hearts. A centrifugal LVAD was implanted under general anesthesia. We inserted the conductance catheters into the left ventricle (LV) and right ventricle (RV) to assess the volume signal simultaneously. We defined the interventricular dyssynchrony as a signal (increase or decrease) of LV volume (LVV) change opposite to that of RV volume (RVV) (i.e., (dLVV/dt) × (dRVV/dt) < 0). The duration of interventricular dyssynchrony (DYS) was reported as the percentage of time that a heart was in a dyssynchronous state within a cardiac cycle. The mean DYS of normal hearts, hearts with LVAD clamp and hearts supported by LVADs with a bypass rate of 50%, 75% and 100% were 5.6 ± 1.6%, 8.7 ± 2.4%, 8.6 ± 2.8%, 15.1 ± 5.1%, and 25.6 ± 8.0%, respectively. Furthermore, the DYS was found to be associated with the degree of LV stroke volume reduction caused by LV unloading. These findings may be useful for understanding interventricular interactions and physiology during CF-LVAD support. Influences on the right ventricular function and heart failure models warrant further study.

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Authors and Affiliations

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

    Junichi Shimamura, Toshihide Mizuno, Yoshiaki Takewa, Tomonori Tsukiya, Ayako Inatomi, Masahiko Ando, Akihide Umeki, Noritsugu Naito & Eisuke Tatsumi

  2. Department of Cardiac Surgery, Tokyo Metropolitan Geriatric Medical Center, Tokyo, Japan

    Takashi Nishimura

  3. Department of Cardiac Surgery, University of Tokyo, Tokyo, Japan

    Junichi Shimamura, Masahiko Ando, Akihide Umeki, Noritsugu Naito & Minoru Ono

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  1. Junichi Shimamura
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  2. Takashi Nishimura
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  3. Toshihide Mizuno
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  4. Yoshiaki Takewa
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Correspondence to Junichi Shimamura.

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Shimamura, J., Nishimura, T., Mizuno, T. et al. Quantification of interventricular dyssynchrony during continuous-flow left ventricular assist device support. J Artif Organs 22, 269–275 (2019). https://doi.org/10.1007/s10047-019-01109-3

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  • DOI: https://doi.org/10.1007/s10047-019-01109-3

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