The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities.
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.
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.
Published inCurrent Hypertension Reports
- VoR (Version of Record)
CitationCastagna, F., Stohr, E.J., Pinsino, A., Cockcroft, J.R., Willey, J., Reshad Garan, A., Topkara, V.K., Colombo, P.C., Yuzefpolskaya, M. and McDonnell, B.J. (2017) 'The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities', Current Hypertension Reports, DOI 10.1007/s11906-017-0782-6
Cardiff Met Affiliation
- Cardiff School of Sport and Health Sciences
Cardiff Met AuthorsEric J Stohr Barry McDonnell
Cardiff Met Research Centre/Group
- Cardiovascular Physiology
- © The Authors