The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities

Publikation: Beitrag in FachzeitschriftÜbersichtsarbeitForschungPeer-Review

Autoren

  • Francesco Castagna
  • Eric J. Stöhr
  • Alberto Pinsino
  • John R. Cockcroft
  • Joshua Willey
  • A. Reshad Garan
  • Veli K. Topkara
  • Paolo C. Colombo
  • Melana Yuzefpolskaya
  • Barry J. McDonnell

Externe Organisationen

  • Columbia University
  • Yale New Haven Health System
  • Cardiff Metropolitan University
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Details

OriginalspracheEnglisch
Aufsatznummer85
FachzeitschriftCurrent hypertension reports
Jahrgang19
Ausgabenummer10
PublikationsstatusVeröffentlicht - 1 Okt. 2017
Extern publiziertJa

Abstract

An increasing number of end-stage heart failure patients are now implanted with continuous-flow left ventricular assist devices (CF-LVADs). Although this therapeutic approach is associated with improved clinical outcomes, continuous flow physiology reduces arterial pulse pressure and pulsatility to an extent that is unique to this population. Recent data suggest that high blood pressure (BP) contributes to life-threatening complications such as pump thrombosis and stroke of CF-LVAD patients. However, limited understanding of the distinct hemodynamics of these pumps makes measurement and, consequently, medical management of BP quite challenging. Here, we review the evolution of LVAD design, the impact of CF-LVAD flow, and “artificial pulse” technology on hemodynamics and BP measurement, as well as suggest new approaches for the assessment and interpretation of the unique physiology of modern LVADs.

ASJC Scopus Sachgebiete

Zitieren

The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities. / Castagna, Francesco; Stöhr, Eric J.; Pinsino, Alberto et al.
in: Current hypertension reports, Jahrgang 19, Nr. 10, 85, 01.10.2017.

Publikation: Beitrag in FachzeitschriftÜbersichtsarbeitForschungPeer-Review

Castagna, F, Stöhr, EJ, Pinsino, A, Cockcroft, JR, Willey, J, Reshad Garan, A, Topkara, VK, Colombo, PC, Yuzefpolskaya, M & McDonnell, BJ 2017, 'The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities', Current hypertension reports, Jg. 19, Nr. 10, 85. https://doi.org/10.1007/s11906-017-0782-6
Castagna, F., Stöhr, E. J., Pinsino, A., Cockcroft, J. R., Willey, J., Reshad Garan, A., Topkara, V. K., Colombo, P. C., Yuzefpolskaya, M., & McDonnell, B. J. (2017). The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities. Current hypertension reports, 19(10), Artikel 85. https://doi.org/10.1007/s11906-017-0782-6
Castagna F, Stöhr EJ, Pinsino A, Cockcroft JR, Willey J, Reshad Garan A et al. The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities. Current hypertension reports. 2017 Okt 1;19(10):85. doi: 10.1007/s11906-017-0782-6
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title = "The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities",
abstract = "An increasing number of end-stage heart failure patients are now implanted with continuous-flow left ventricular assist devices (CF-LVADs). Although this therapeutic approach is associated with improved clinical outcomes, continuous flow physiology reduces arterial pulse pressure and pulsatility to an extent that is unique to this population. Recent data suggest that high blood pressure (BP) contributes to life-threatening complications such as pump thrombosis and stroke of CF-LVAD patients. However, limited understanding of the distinct hemodynamics of these pumps makes measurement and, consequently, medical management of BP quite challenging. Here, we review the evolution of LVAD design, the impact of CF-LVAD flow, and “artificial pulse” technology on hemodynamics and BP measurement, as well as suggest new approaches for the assessment and interpretation of the unique physiology of modern LVADs.",
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note = "Funding Information: Funding Information This project has received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation program under the Marie Sk{\l}odowska-Curie grant agreement no. 705219 and from the Lisa and Mark Schwartz Program to Reverse Heart Failure at New York-Presbyterian Hospital/Columbia University. ",
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T2 - Current Challenges and Future Opportunities

AU - Castagna, Francesco

AU - Stöhr, Eric J.

AU - Pinsino, Alberto

AU - Cockcroft, John R.

AU - Willey, Joshua

AU - Reshad Garan, A.

AU - Topkara, Veli K.

AU - Colombo, Paolo C.

AU - Yuzefpolskaya, Melana

AU - McDonnell, Barry J.

N1 - Funding Information: Funding Information This project has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement no. 705219 and from the Lisa and Mark Schwartz Program to Reverse Heart Failure at New York-Presbyterian Hospital/Columbia University.

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Y1 - 2017/10/1

N2 - An increasing number of end-stage heart failure patients are now implanted with continuous-flow left ventricular assist devices (CF-LVADs). Although this therapeutic approach is associated with improved clinical outcomes, continuous flow physiology reduces arterial pulse pressure and pulsatility to an extent that is unique to this population. Recent data suggest that high blood pressure (BP) contributes to life-threatening complications such as pump thrombosis and stroke of CF-LVAD patients. However, limited understanding of the distinct hemodynamics of these pumps makes measurement and, consequently, medical management of BP quite challenging. Here, we review the evolution of LVAD design, the impact of CF-LVAD flow, and “artificial pulse” technology on hemodynamics and BP measurement, as well as suggest new approaches for the assessment and interpretation of the unique physiology of modern LVADs.

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