用于射血分数保留型心力衰竭的 HeartMate 3:体外血流动力学评估和解剖匹配。

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL
Nina Langer, Andrew F. Stephens, Michael Šeman, David McGiffin, David M. Kaye, Shaun D. Gregory
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引用次数: 0

摘要

射血分数保留型心力衰竭(HFpEF)约占心力衰竭(HF)病例的 50%,并包括不同的表型。其中,大多数射血分数保留型心力衰竭患者的心脏结构发生了变化,左心室腔通常较小,这给使用心室辅助装置(VAD)带来了挑战。从左心房到主动脉(LA-Ao)的 VAD 配置可以应对这些挑战,通过降低升高的平均左心房压(MLAP),有可能提高患者的生活质量。本研究使用模拟 VAD 支持的高频血友病患者评估了解剖兼容性和左心房卸载能力。使用心血管模拟器模拟了一名 LA-Ao 配置的 HeartMate3 支持型 HFpEF 患者。在七种泵流量下记录静息和运动时的血流动力学参数。对 14 名 HFpEF(NYHA II-III)和 6 名射血分数降低的心力衰竭患者的计算机断层扫描进行分析,以进行解剖学比较。独立评估了 HFpEF 模型与 LA-Ao 配置中的 HM3 的虚拟解剖匹配度。在静息状态下,增加 1 L/min HM3 支持后,基线 MLAP 从 15 mmHg 降至 11 mmHg。在运动模拟中,需要 6 L/min 的 HM3 支持才能将 MLAP 从 29 mmHg 降低到 16 mmHg。HM3 成功地为六名高频低氧血症患者提供了支持,没有对其他心脏结构造成干扰,而对其余患者造成了 4 至 14 毫米的撞击。这项研究表明,LA-Ao 配置的 HM3 可能适用于一些 HFpEF 患者,为左心房减压并缓解肺充血,这些患者的尺寸限制可以通过术前解剖匹配分析来解决。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

HeartMate 3 for Heart Failure with Preserved Ejection Fraction: In Vitro Hemodynamic Evaluation and Anatomical Fitting

HeartMate 3 for Heart Failure with Preserved Ejection Fraction: In Vitro Hemodynamic Evaluation and Anatomical Fitting

Heart failure with preserved ejection fraction (HFpEF) constitutes approximately 50% of heart failure (HF) cases, and encompasses different phenotypes. Among these, most patients with HFpEF exhibit structural heart changes, often with smaller left ventricular cavities, which pose challenges for utilizing ventricular assist devices (VADs). A left atrial to aortic (LA-Ao) VAD configuration could address these challenges, potentially enhancing patient quality of life by lowering elevated mean left atrial pressure (MLAP). This study assessed the anatomical compatibility and left atrial unloading capacity using a simulated VAD-supported HFpEF patient. A HeartMate3-supported HFpEF patient in an LA-Ao configuration was simulated using a cardiovascular simulator. Hemodynamic parameters were recorded during rest and exercise at seven pump flow rates. Computed tomography scans of 14 HFpEF (NYHA II–III) and six heart failure with reduced ejection fraction patients were analysed for anatomical comparisons. HFpEF models were independently assessed for virtual anatomical fit with the HM3 in the LA-Ao configuration. Baseline MLAP was reduced from 15 to 11 mmHg with the addition of 1 L/min HM3 support in the rest condition. In an exercise simulation, 6 L/min of HM3 support was required to reduce the MLAP from 29 to 16 mmHg. The HM3 successfully accommodated six HFpEF patients without causing interference with other cardiac structures, whereas it caused impingement ranging from 4 to 14 mm in the remaining patients. This study demonstrated that the HM3 in an LA-Ao configuration may be suitable for unloading the left atrium and relieving pulmonary congestion in some HFpEF patients where size-related limitations can be addressed through pre-surgical anatomical fit analysis.

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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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