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Dynamic biventricular response to alterations in preload in patients undergoing left ventricular device implantation

Mandarino, WA and Kormos, RL and Kawai, A and Gasior, TA and Pinsky, MR and Griffith, BP (1994) Dynamic biventricular response to alterations in preload in patients undergoing left ventricular device implantation. ASAIO Journal, 40 (3). ISSN 1058-2916

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Ventricular interdependence is important for the successful use of a left ventricular assist device (LVAD) because the filling of the device depends on right ventricular (RV) function as well as the interactions between the ventricles. The pulmonary arterial (PAP) and systemic arterial (AP) response to inferior vena caval (IVC) occlusion before and after insertion of an LVAD in 15 patients was used to `dissect out' the determinants of these interactions. PAP and AP were recorded during each IVC occlusion and peak systolic values calculated for each beat. Linear regression analysis was used to calculate the slope (k) between peak systolic AP values and peak systolic PAP values. k, a measure of preload responsiveness of the heart, is predominantly linear. k is relatively `flat' in selected LV failure patients pre-LVAD but increases significantly (P<0.001) after LVAD (0.67±0.55 vs. 2.71±1.39). The increase in this parameter after LVAD suggests that the loss of RV-to-LV ventricular interdependence in patients with congestive heart failure appears to recover somewhat once an LVAD is inserted.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Mandarino, WA
Kormos, RLkormos@pitt.eduKORMOS
Kawai, A
Gasior, TA
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Griffith, BP
Date: 1 January 1994
Date Type: Publication
Journal or Publication Title: ASAIO Journal
Volume: 40
Number: 3
DOI or Unique Handle: 10.1097/00002480-199407000-00011
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 1058-2916
PubMed ID: 8555527
Date Deposited: 05 Mar 2012 17:07
Last Modified: 30 Jan 2020 16:55


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