The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities

被引：67
作者：
Castagna, Francesco [1 ,2 ]
Stohr, Eric J. [1 ,3 ]
Pinsino, Alberto [1 ]
Cockcroft, John R. [3 ]
Willey, Joshua [4 ]
Garan, A. Reshad [1 ]
Topkara, Veli K. [1 ]
Colombo, Paolo C. [1 ]
Yuzefpolskaya, Melana [1 ]
McDonnell, Barry J. [3 ]
机构：
[1] Columbia Univ, Med Ctr, Div Cardiol, New York, NY USA
[2] Yale New Haven Hlth, Dept Med, Bridgeport, CT USA
[3] Cardiff Metropolitan Univ, Sch Hlth Sci, Cardiff CF5 2YB, S Glam, Wales
[4] Columbia Univ, Med Ctr, Dept Neurol, New York, NY USA
来源：
CURRENT HYPERTENSION REPORTS | 2017年 / 19卷 / 10期
关键词：
Left ventricular assist device; Blood pressure; Continuous flow; Mechanical circulatory support; Hemodynamics; Heart failure; VENTRICULAR ASSIST SYSTEM; INTERNATIONAL SOCIETY; HEART; OUTCOMES; EVENTS; PUMP; TRANSPLANT;
D O I：
10.1007/s11906-017-0782-6
中图分类号：
R6 [外科学];
学科分类号：
1002 ; 100210 ;
摘要：
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.
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页数：7
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