TY - JOUR
T1 - Pump speed optimization in stable patients with a left ventricular assist device
AU - Couperus, Lotte E.
AU - Delgado, Victoria
AU - Khidir, Mand J. H.
AU - Vester, Marijke P. M.
AU - Palmen, Meindert
AU - Fiocco, Marta
AU - Holman, Eduard R.
AU - Tops, Laurens F.
AU - Klautz, Robert J. M.
AU - Verwey, Harriëtte F.
AU - Schalij, Martin J.
AU - Beeres, Saskia L. M. A.
PY - 2017
Y1 - 2017
N2 - Optimal left ventricular assist device (LVAD) functioning and preservation of right ventricular (RV) function are major survival determinants in destination therapy (DT)-LVAD recipients, Currently, the indication for routine pump speed optimization in stable patients and its effect on RV function at follow-up remain underexplored, Hemodynamically stable patients (N = 17, age 61 [interquartile range {IQR} 51-66] years; 13 [77%] male) underwent a routine speed ramp test, Echocardiographic images were obtained at incremental speed settings to determine optimal pump speed, In 8 patients (47%), LVAD speed could be optimized, In these patients, RV fractional area change (26% [IQR 23-31] to 35% [IQR 27-45], p = 0.04) and RV longitudinal peak systolic strain (-13% [IQR -16 to -9] to -17% [IQR -18 to -11], p = 0.02) at 3 months follow-up improved without RV dilatation, Furthermore, N-terminal pro-brain natriuretic peptide level decreased (3,162 [IQR 1,336-4,487] ng/L to 2,294 [IQR 1,157-3,810] ng/L, p = 0.02), No significant follow-up changes were found in patients without indication for speed adjustment, In conclusion, routine evaluation of optimal LVAD speed reveals the potential of speed optimization in a substantial proportion of stable LVAD-DT patients and can improve RV function,
AB - Optimal left ventricular assist device (LVAD) functioning and preservation of right ventricular (RV) function are major survival determinants in destination therapy (DT)-LVAD recipients, Currently, the indication for routine pump speed optimization in stable patients and its effect on RV function at follow-up remain underexplored, Hemodynamically stable patients (N = 17, age 61 [interquartile range {IQR} 51-66] years; 13 [77%] male) underwent a routine speed ramp test, Echocardiographic images were obtained at incremental speed settings to determine optimal pump speed, In 8 patients (47%), LVAD speed could be optimized, In these patients, RV fractional area change (26% [IQR 23-31] to 35% [IQR 27-45], p = 0.04) and RV longitudinal peak systolic strain (-13% [IQR -16 to -9] to -17% [IQR -18 to -11], p = 0.02) at 3 months follow-up improved without RV dilatation, Furthermore, N-terminal pro-brain natriuretic peptide level decreased (3,162 [IQR 1,336-4,487] ng/L to 2,294 [IQR 1,157-3,810] ng/L, p = 0.02), No significant follow-up changes were found in patients without indication for speed adjustment, In conclusion, routine evaluation of optimal LVAD speed reveals the potential of speed optimization in a substantial proportion of stable LVAD-DT patients and can improve RV function,
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85002251379&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/27922889
U2 - https://doi.org/10.1097/MAT.0000000000000483
DO - https://doi.org/10.1097/MAT.0000000000000483
M3 - Article
C2 - 27922889
SN - 1058-2916
VL - 63
SP - 266
EP - 272
JO - ASAIO journal (American Society for Artificial Internal Organs
JF - ASAIO journal (American Society for Artificial Internal Organs
IS - 3
ER -