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HeartWare Left Ventricular Assist Device Exercise Hemodynamics With Speed Adjustment Based on Left Ventricular Filling Pressures.
- Source :
-
ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2024 Jun 01; Vol. 70 (6), pp. e82-e88. Date of Electronic Publication: 2023 Nov 29. - Publication Year :
- 2024
-
Abstract
- Functional capacity remains limited in heart failure patients with left ventricular assist devices (LVADs) due to fixed pump speed and inability to offload the left ventricle adequately. We hypothesized that manually adjusting LVAD speed during exercise based on pulmonary capillary wedge pressures would increase total cardiac output and maximal oxygen consumption. Two participants with a HeartWare LVAD underwent an invasive ramp study at rest followed by an invasive cardiopulmonary stress test exercising in two randomized phases: fixed speed and adjusted speed. In the latter phase, speed was adjusted every 1 minute during exercise at ±20 rpm/1 mm Hg change from baseline pulmonary capillary wedge pressure. There was no difference in maximal oxygen consumption between the two phases, with a modest increase in total cardiac output during speed adjustment. Filling pressures were initially controlled during speed adjustment until speed was capped at 4,000 rpm, at which point filling pressures increased. Blood pressure was variable. The pressure across the head of the pump (ΔP) was higher with speed adjustment. Contrary to our hypothesis, LVAD speed adjustment during exercise did not improve total cardiac output and functional capacity. This variable response may be attributed to the native cardiac reserve and baroreceptor response; however, additional studies are needed.<br />Competing Interests: Disclosure: The authors have no conflicts of interest to report.<br /> (Copyright © ASAIO 2023.)
- Subjects :
- Humans
Male
Middle Aged
Female
Cardiac Output physiology
Oxygen Consumption physiology
Ventricular Function, Left physiology
Exercise Test
Pulmonary Wedge Pressure physiology
Adult
Heart-Assist Devices
Hemodynamics physiology
Heart Failure physiopathology
Heart Failure therapy
Heart Failure surgery
Exercise physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1538-943X
- Volume :
- 70
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- ASAIO journal (American Society for Artificial Internal Organs : 1992)
- Publication Type :
- Academic Journal
- Accession number :
- 38029762
- Full Text :
- https://doi.org/10.1097/MAT.0000000000002096