Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance
The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventri...
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| Format: | Article |
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MDPI AG
2022-04-01
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| Series: | Bioengineering |
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| Online Access: | https://www.mdpi.com/2306-5354/9/5/181 |
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| author | Beatrice De Lazzari Attilio Iacovoni Massimo Capoccia Silvia Papa Roberto Badagliacca Domenico Filomena Claudio De Lazzari |
| author_facet | Beatrice De Lazzari Attilio Iacovoni Massimo Capoccia Silvia Papa Roberto Badagliacca Domenico Filomena Claudio De Lazzari |
| author_sort | Beatrice De Lazzari |
| collection | DOAJ |
| description | The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventricular elastance (Ees<sub>RIGHT</sub>) was modified using numerical simulations based on atrial and ventricular pressure–volume analysis. We considered the effects induced by continuous-flow RVAD support on left/right ventricular/atrial loops when Ees<sub>RIGHT</sub> changed from 0.3 to 0.8 mmHg/mL during in-series or parallel pump connection. Pump rotational speed was also addressed. Parallel RVAD support at 4000 rpm with Ees<sub>RIGHT</sub> = 0.3 mmHg/mL generated percentage changes up to 60% for left ventricular pressure–volume area and external work; up to 20% for left ventricular ESV and up to 25% for left ventricular EDV; up to 50% change in left atrial pressure-volume area (PVLA<sub>L-A</sub>) and only a 3% change in right atrial pressure–volume area (PVLA<sub>R-A</sub>). Percentage variation was lower when Ees<sub>RIGHT</sub> = 0.8 mmHg/mL. Early recognition of right ventricular failure followed by aggressive treatment is desirable, so as to achieve a more favourable outcome. RVAD support remains an option for advanced right ventricular failure, although the onset of major adverse events may preclude its use. |
| first_indexed | 2024-03-10T03:19:09Z |
| format | Article |
| id | doaj.art-181b8a021bbb472fbe8ac9e863c34e77 |
| institution | Directory Open Access Journal |
| issn | 2306-5354 |
| language | English |
| last_indexed | 2024-03-10T03:19:09Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Bioengineering |
| spelling | doaj.art-181b8a021bbb472fbe8ac9e863c34e772023-11-23T10:05:23ZengMDPI AGBioengineering2306-53542022-04-019518110.3390/bioengineering9050181Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump AssistanceBeatrice De Lazzari0Attilio Iacovoni1Massimo Capoccia2Silvia Papa3Roberto Badagliacca4Domenico Filomena5Claudio De Lazzari6Department of Human Movement and Sport Sciences, “Foro Italico” 4th University of Rome, 00135 Rome, ItalyDepartment of Cardiology, ASST-Papa Giovanni XIII Hospital, 24127 Bergamo, ItalyDepartment of Cardiac Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UKDepartment of Clinical, Internal Anesthesiology and Cardiovascular Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyDepartment of Clinical, Internal Anesthesiology and Cardiovascular Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyDepartment of Clinical, Internal Anesthesiology and Cardiovascular Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyNational Research Council, Institute of Clinical Physiology (IFC-CNR), 00185 Rome, ItalyThe main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventricular elastance (Ees<sub>RIGHT</sub>) was modified using numerical simulations based on atrial and ventricular pressure–volume analysis. We considered the effects induced by continuous-flow RVAD support on left/right ventricular/atrial loops when Ees<sub>RIGHT</sub> changed from 0.3 to 0.8 mmHg/mL during in-series or parallel pump connection. Pump rotational speed was also addressed. Parallel RVAD support at 4000 rpm with Ees<sub>RIGHT</sub> = 0.3 mmHg/mL generated percentage changes up to 60% for left ventricular pressure–volume area and external work; up to 20% for left ventricular ESV and up to 25% for left ventricular EDV; up to 50% change in left atrial pressure-volume area (PVLA<sub>L-A</sub>) and only a 3% change in right atrial pressure–volume area (PVLA<sub>R-A</sub>). Percentage variation was lower when Ees<sub>RIGHT</sub> = 0.8 mmHg/mL. Early recognition of right ventricular failure followed by aggressive treatment is desirable, so as to achieve a more favourable outcome. RVAD support remains an option for advanced right ventricular failure, although the onset of major adverse events may preclude its use.https://www.mdpi.com/2306-5354/9/5/181heart failureRVADpressure-volume looplumped parameter modelsoftware simulationcardiovascular modelling |
| spellingShingle | Beatrice De Lazzari Attilio Iacovoni Massimo Capoccia Silvia Papa Roberto Badagliacca Domenico Filomena Claudio De Lazzari Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance Bioengineering heart failure RVAD pressure-volume loop lumped parameter model software simulation cardiovascular modelling |
| title | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
| title_full | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
| title_fullStr | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
| title_full_unstemmed | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
| title_short | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
| title_sort | ventricular and atrial pressure volume loops analysis of the effects induced by right centrifugal pump assistance |
| topic | heart failure RVAD pressure-volume loop lumped parameter model software simulation cardiovascular modelling |
| url | https://www.mdpi.com/2306-5354/9/5/181 |
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