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Ivak P, Netuka I, Tucanova Z, et al. The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices. Can J Cardiol. 2021;37(10):1578-1585doi: 10.1016/j.cjca.2021.05.013.
Ivak, P., Netuka, I., Tucanova, Z., Wohlfahrt, P., Konarik, M., Szarszoi, O., Novakova, S., Kubanek, M., Lanska, V., & Pitha, J. (2021). The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices. The Canadian journal of cardiology, 37(10), 1578-1585. https://doi.org/10.1016/j.cjca.2021.05.013
Ivak, Peter, et al. "The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices." The Canadian journal of cardiology vol. 37,10 (2021): 1578-1585. doi: https://doi.org/10.1016/j.cjca.2021.05.013
Ivak P, Netuka I, Tucanova Z, Wohlfahrt P, Konarik M, Szarszoi O, Novakova S, Kubanek M, Lanska V, Pitha J. The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices. Can J Cardiol. 2021 Oct;37(10):1578-1585. doi: 10.1016/j.cjca.2021.05.013. Epub 2021 Jun 06. PMID: 34090978.
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Can J Cardiol. 2021 Oct;37(10):1578-1585. doi: 10.1016/j.cjca.2021.05.013. Epub 2021 Jun 06.

The Effect of Artificial Pulsatility on the Peripheral Vasculature in Patients With Continuous-Flow Ventricular Assist Devices.

The Canadian journal of cardiology

Peter Ivak, Ivan Netuka, Zuzana Tucanova, Peter Wohlfahrt, Miroslav Konarik, Ondrej Szarszoi, Sarka Novakova, Milos Kubanek, Vera Lanska, Jan Pitha

Affiliations

  1. Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic; Second Department of Surgery, Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University, Prague, Czech Republic. Electronic address: [email protected].
  2. Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Second Department of Surgery, Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University, Prague, Czech Republic.
  3. Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
  4. Laboratory for Atherosclerosis Research, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
  5. Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Institute of Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
  6. Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
  7. Medical Statistics Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
  8. Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.

PMID: 34090978 DOI: 10.1016/j.cjca.2021.05.013

Abstract

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.

Copyright © 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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