TY - JOUR

T1 - Bionic women and men - Part 2

T2 - Arterial stiffness in heart failure patients implanted with left ventricular assist devices

AU - McDonnell, Barry J.

AU - Rosenblum, Hannah

AU - Cornwell, William K.

AU - Kanwar, Manreet

AU - Cockcroft, John R.

AU - Stöhr, Eric J.

N1 - Funding Information: The authors thank The Physiological Society for the opportunity to present this symposium at The Society's annual meeting 2019 in Aberdeen, UK, and for the invitation to write the reports from the meeting in Experiment Physiology. Funding Information: E.J.S. and B.J.M. have received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska‐Curie grant agreement no. 705219. B.C. has received funding by an NIH/NHLBI Mentored Patient Oriented Research Career Development Award (#1K23HLI32048‐01) and by the NIH/NCATS (#UL1TR002535), Susie and Kurt Lochmiller Distinguished Heart Transplant Fund, the Clinical Translational Science Institute at the University of Colorado Anschutz, and the Medical Campus and Medtronic Inc. M.K. has received Research funding by Abbott Inc., but none relevant to this submission.

PY - 2020/5/1

Y1 - 2020/5/1

N2 - New Findings: What is the topic of this review? This review discusses how implantation of continuous flow left ventricular assist devices impact arterial stiffness and outcome. What advances does it highlight? Not all patients implanted with continuous flow left ventricular assist devices show an increase in arterial stiffness. However, in those patients where arterial stiffness increases, levels of composite outcome (stroke, gastrointestinal bleeding, pump thrombosis and death) is significantly higher than those who's arterial stiffness does not increase. Abstract: In parallel with the major advances in clinical care, technological advancements and implantation of mechanical circulatory support in patients with severe heart failure have resulted in these patients living longer. However, these patients are still at increased risk of stroke and gastrointestinal bleeding. The unique continuous flow produced by various left ventricular assist devices (LVADs) has been suggested as one potential reason for this increased risk of stroke and gastrointestinal bleeding. Furthermore, these continuous-flow (CF) devices challenge our understanding of circulatory blood pressure and flow regulation in relationship to organ health. In healthy pulsatile and dynamic systems, arterial stiffness is a major independent risk factor for stroke. However, to date, there are limited data regarding the impact of CF-LVAD therapy on arterial stiffness. The purpose of this report is to discuss the variable impact of CF-LVAD therapy on arterial stiffness and attempt to highlight some potential mechanisms linking these associations in this unique population.

AB - New Findings: What is the topic of this review? This review discusses how implantation of continuous flow left ventricular assist devices impact arterial stiffness and outcome. What advances does it highlight? Not all patients implanted with continuous flow left ventricular assist devices show an increase in arterial stiffness. However, in those patients where arterial stiffness increases, levels of composite outcome (stroke, gastrointestinal bleeding, pump thrombosis and death) is significantly higher than those who's arterial stiffness does not increase. Abstract: In parallel with the major advances in clinical care, technological advancements and implantation of mechanical circulatory support in patients with severe heart failure have resulted in these patients living longer. However, these patients are still at increased risk of stroke and gastrointestinal bleeding. The unique continuous flow produced by various left ventricular assist devices (LVADs) has been suggested as one potential reason for this increased risk of stroke and gastrointestinal bleeding. Furthermore, these continuous-flow (CF) devices challenge our understanding of circulatory blood pressure and flow regulation in relationship to organ health. In healthy pulsatile and dynamic systems, arterial stiffness is a major independent risk factor for stroke. However, to date, there are limited data regarding the impact of CF-LVAD therapy on arterial stiffness. The purpose of this report is to discuss the variable impact of CF-LVAD therapy on arterial stiffness and attempt to highlight some potential mechanisms linking these associations in this unique population.

UR - http://www.scopus.com/inward/record.url?scp=85083052103&partnerID=8YFLogxK

U2 - 10.1113/EP088326

DO - 10.1113/EP088326

M3 - Article

C2 - 32144954

AN - SCOPUS:85083052103

VL - 105

SP - 755

EP - 758

JO - Experimental physiology

JF - Experimental physiology

SN - 0958-0670

IS - 5

ER -