title: Effect of pump flow mode of novel left ventricular assist device upon end organ perfusion in dogs with doxorubicin induced heart failure.
abstract: End organ effects of nonpulsatile (NP) and pulsatile (P) left ventricular assist device (LVAD) flow were compared in a canine model of doxorubicin-induced heart failure. After heart failure induction, a prototype bimodal LVAD was implanted. Hemodynamics, cardiac dimensions, and myocardial metabolism were monitored with the LVAD off (baseline) and on (in NP and P modes at 70% or 100% power). End organ perfusion was assessed by colored microsphere analysis. Seven dogs were used: two died before pump implantation and were excluded from analysis, and the remaining five survived to study termination. At 70% NP, ascending aortic flow and myocardial oxygen consumption (MVO2) decreased significantly. At 100% NP, LV dimensions decreased, aortic systolic, pulse, and LV pressures decreased but not significantly, and ascending aorta flow reversed. At 100% NP, coronary blood flow, MVO2, and LV free wall subepicardial and subendocardial blood flows decreased significantly. However, as NP support increased, the subepicardial/subendocardial blood flow ratio remained near baseline. At 100% NP, right ventricular perfusion decreased but not significantly, cerebral perfusion decreased significantly, and renal perfusion stayed constant. P mode results were similar, except that ascending aorta flow decreased significantly at 100% P instead of reversing as at 100% NP. These results suggest that end organ perfusion is not differentially affected by LVAD flow mode during chronic heart failure.
authors.affiliation: Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Eya
authors.forename: Egemen
authors.initials: E
authors.lastname: Tuzun
authors.forename: Jeff
authors.initials: J
authors.lastname: Conger
authors.forename: Hyun K
authors.initials: HK
authors.lastname: Chee
authors.forename: Denise
authors.initials: D
authors.lastname: Byler
authors.forename: Chisato
authors.initials: C
authors.lastname: Nojiri
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
authors.forename: Kamuran
authors.initials: K
authors.lastname: Kadipasaoglu
mesh_terms: D000818:Animals; D001011:Aorta / Q000502:physiology; D001013:Aorta, Thoracic / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D015908:Counterpulsation; D004285:Dogs; D004317:Doxorubicin; D006333:Heart Failure / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D006353:Heart-Assist Devices; D006439:Hemodynamics; D009206:Myocardium / Q000648:ultrastructure; D010477:Perfusion; D011673:Pulsatile Flow; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D004317:Doxorubicin