title: Evaluation of myocardial function in patients with end-stage heart failure during support with the Jarvik 2000 left ventricular assist device.
abstract: In 2 patients with the Jarvik 2000 left ventricular assist device (LVAD), we assessed left ventricular systolic function through pressure-volume loops and E(max) at the beginning and end of the support period to potentially predict the possibility of pump removal without transplantation. Immediately before LVAD implantation and explantation, pressure and volume measurements were made with catheters and echocardiography, respectively, the E(max) being calculated from the slope of the pressure-volume loops, and the left ventricular ejection fraction (LVEF) being estimated by echocardiography. Transplantation was performed after 14 and 62 days, respectively, during which the LVEF increased by 75% (from 12% to 21%) in Patient 1 and remained unchanged (from 16% to 18%) in Patient 2, whereas the E(max) increased from 0.63 and 0.42 mm Hg/ml, respectively, to 1.31 and 1.07 mm Hg/ml, reflecting a 107% and 155% improvement. In these 2 cases, the E(max) was a more reliable indicator of intrinsic myocardial contractility than was the LVEF.
authors.affiliation: Texas Heart Institute, Houston, TX 77225, USA.
authors.forename: Markus
authors.initials: M
authors.lastname: Ferrari
authors.forename: Kamuran A
authors.initials: KA
authors.lastname: Kadipasaoglu
authors.forename: Mihai
authors.initials: M
authors.lastname: Croitoru
authors.forename: Jeff
authors.initials: J
authors.lastname: Conger
authors.forename: Tim
authors.initials: T
authors.lastname: Myers
authors.forename: Igor
authors.initials: I
authors.lastname: Gregoric
authors.forename: Branislav
authors.initials: B
authors.lastname: Radovancevic
authors.forename: George V
authors.initials: GV
authors.lastname: Letsou
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D013318:Stroke Volume; D013599:Systole; D016277:Ventricular Function, Left