Details
Original language | English |
---|---|
Pages (from-to) | 759-762 |
Number of pages | 4 |
Journal | Experimental physiology |
Volume | 105 |
Issue number | 5 |
Publication status | Published - 1 May 2020 |
Externally published | Yes |
Abstract
New Findings: What is the topic of this review? Right heart dysfunction remains a major adverse event in patients with end stage heart failure undergoing left ventricular assist device placement. This article reviews the pathophysiology and clinical considerations of right heart failure in this patient population. What advances does it highlight? This review highlights the anatomic and physiological peculiarities of the interplay between left and right heart function in patients undergoing LVAD therapy. These would allow us to further advance our understanding of right ventricular function. Abstract: The adaptation of the right ventricular (RV) output to a left ventricular assist device (LVAD) often determines the fate of patients with pulmonary hypertension secondary to left heart failure. Pre-existing right heart dysfunction in patients with advanced left heart failure is the consequence of increased (arterial) afterload and not simply the consequence of myocardial disease. If unaccounted for, it has the potential of accelerating into clinical right heart failure after LVAD, leading to significant morbidity and mortality. After LVAD implantation, the RV has to face increased flow generated by the LVAD, cardiac arrhythmias and exaggerated functional interactions between both ventricles. Understanding the key physiological mechanisms of RV dysfunction in patients with end-stage heart failure will allow us to predict and therefore prevent RV failure after LVAD implantation.
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)
- Physiology
- Nursing(all)
- Nutrition and Dietetics
- Medicine(all)
- Physiology (medical)
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In: Experimental physiology, Vol. 105, No. 5, 01.05.2020, p. 759-762.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Bionic women and men - Part 3
T2 - Right ventricular dysfunction in patients implanted with left ventricular assist devices
AU - Kanwar, Manreet
AU - McDonnell, Barry J.
AU - Rosenblum, Hannah
AU - Cockcroft, John R.
AU - Stöhr, Eric J.
AU - Cornwell, William K.
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 present the reports from the meeting in Experimental Physiology. Funding Information: Dr Kanwar has received research funding by Abbott Inc. but none relevant to this submission. Drs McDonnell and Stöhr have received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska‐Curie grant agreement No 705219. Dr. Cornwell has received funding by an NIH/NHLBI Mentored Patient‐33 Oriented Research Career Development Award (#1K23HLI32048‐01), as well as the 34 NIH/NCATS (#UL1TR002535), Susie and Kurt Lochmiller Distinguished Heart Transplant 35 Fund, the Clinical Translational Science Institute at the University of Colorado Anschutz 36 Medical Campus, and Medtronic Inc.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - New Findings: What is the topic of this review? Right heart dysfunction remains a major adverse event in patients with end stage heart failure undergoing left ventricular assist device placement. This article reviews the pathophysiology and clinical considerations of right heart failure in this patient population. What advances does it highlight? This review highlights the anatomic and physiological peculiarities of the interplay between left and right heart function in patients undergoing LVAD therapy. These would allow us to further advance our understanding of right ventricular function. Abstract: The adaptation of the right ventricular (RV) output to a left ventricular assist device (LVAD) often determines the fate of patients with pulmonary hypertension secondary to left heart failure. Pre-existing right heart dysfunction in patients with advanced left heart failure is the consequence of increased (arterial) afterload and not simply the consequence of myocardial disease. If unaccounted for, it has the potential of accelerating into clinical right heart failure after LVAD, leading to significant morbidity and mortality. After LVAD implantation, the RV has to face increased flow generated by the LVAD, cardiac arrhythmias and exaggerated functional interactions between both ventricles. Understanding the key physiological mechanisms of RV dysfunction in patients with end-stage heart failure will allow us to predict and therefore prevent RV failure after LVAD implantation.
AB - New Findings: What is the topic of this review? Right heart dysfunction remains a major adverse event in patients with end stage heart failure undergoing left ventricular assist device placement. This article reviews the pathophysiology and clinical considerations of right heart failure in this patient population. What advances does it highlight? This review highlights the anatomic and physiological peculiarities of the interplay between left and right heart function in patients undergoing LVAD therapy. These would allow us to further advance our understanding of right ventricular function. Abstract: The adaptation of the right ventricular (RV) output to a left ventricular assist device (LVAD) often determines the fate of patients with pulmonary hypertension secondary to left heart failure. Pre-existing right heart dysfunction in patients with advanced left heart failure is the consequence of increased (arterial) afterload and not simply the consequence of myocardial disease. If unaccounted for, it has the potential of accelerating into clinical right heart failure after LVAD, leading to significant morbidity and mortality. After LVAD implantation, the RV has to face increased flow generated by the LVAD, cardiac arrhythmias and exaggerated functional interactions between both ventricles. Understanding the key physiological mechanisms of RV dysfunction in patients with end-stage heart failure will allow us to predict and therefore prevent RV failure after LVAD implantation.
UR - http://www.scopus.com/inward/record.url?scp=85082417373&partnerID=8YFLogxK
U2 - 10.1113/EP088324
DO - 10.1113/EP088324
M3 - Article
C2 - 32103556
AN - SCOPUS:85082417373
VL - 105
SP - 759
EP - 762
JO - Experimental physiology
JF - Experimental physiology
SN - 0958-0670
IS - 5
ER -