Increased Aortic Stiffness is Associated with Higher Rates of Stroke, GI-bleeding and Pump Thrombosis in Continuous-Flow Left Ventricular Assist Device Patients

Rosenblum, Hannah; Pinsino, A.; Demmer, Ryan T.; Colombo, P.C.; Yuzefpolskaya, M.; Garan, A.R.; Topkara, V.K.; Gaudig, A.; Pineda, M.T.; Naka, Yoshifumi; Takayama, Hiroo; Takeda, Koji; Castagna, F.; Willey, Joshua Z.; McDonnell, Barry J.; Cockcroft, JR; Stöhr, Eric J.

doi:10.1016/j.healun.2018.01.058

Cited by 4 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This effect may be even worse in LVAD patients with increased arterial stiffness (see 'Bionic Women andMen. Part 4' by McDonnell et al 2020, Patel et al, 2017;Rosenblum et al, 2018), likely impacting on the brain and GI tract as well as the right heart. It can be expected that the study of the complex interactions between the heart, arterial blood pressure, pulsatility and stiffness in LVAD patients will reveal new insight into the mechanisms that impact cardiovascular health in all humans.…”

Section: The Role Of Pulsatilitymentioning

confidence: 99%

Bionic women and men ‐ Part 1: Cardiovascular lessons from heart failure patients implanted with left ventricular assist devices

Stöhr

Cornwell

Kanwar

et al. 2020

Experimental Physiology

View full text Add to dashboard Cite

Some humans with chronic, advanced heart failure are surgically implanted with a left ventricular assist device (LVAD). Because the LVAD produces a continuous flow, a palpable pulse is often absent in these patients. This allows for a unique investigation of the human circulation and has created a controversy around the 'need' for a pulse. The medical debate has also generated a more generic, fundamental discussion into what is 'normal' arterial physiology and health. The comprehensive study and understanding of the arterial responses to drastically altered haemodynamics due to continuous-flow LVADs, at rest and during activity, presents an opportunity to significantly increase our current understanding of the fundamental components of arterial regulation (flow, blood pressure, sympathetic activity, endothelial function, pulsatility) in a way that could never have been studied previously. In a series of four articles, we summarize the talks presented at the symposium entitled 'Bionic women and men-Physiology lessons from implantable cardiac devices' presented at the 2019 Annual Meeting of The Physiological Society in Aberdeen, UK. The articles highlight the novel questions generated by physiological phenomena observed in LVAD patients and propose future areas of interest within the field of cardiovascular physiology.

show abstract

Section: The Role Of Pulsatilitymentioning

confidence: 99%

Bionic women and men ‐ Part 1: Cardiovascular lessons from heart failure patients implanted with left ventricular assist devices

Stöhr

Cornwell

Kanwar

et al. 2020

Experimental Physiology

View full text Add to dashboard Cite

show abstract

“…However, aortic stiffness did not increase in all patients, and those patients with increased aortic stiffness had the highest risk of the composite outcome of stroke, GI bleeding and pump thrombosis. Interestingly, those individuals with increased aortic stiffness were on CF-LVAD therapy for a longer duration and were on lower numbers of angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) compared with those who had an unaltered or decreased aortic stiffness (Rosenblum et al, 2018). Paradoxically, patients who had an increased stiffness with LVAD therapy had a significantly lower baseline stiffness.…”

Section: Continuous Flow and Arterial Stiffnessmentioning

confidence: 99%

Bionic women and men ‐ Part 2: Arterial stiffness in heart failure patients implanted with left ventricular assist devices

McDonnell

Rosenblum

Cornwell

et al. 2020

Experimental Physiology

View full text Add to dashboard Cite

In parallel with the major advances in clinical care, technological advancements and implantation of mechanical circulatory support in patients with severe heart failure have resulted in these patients living longer. However, these patients are still at increased risk of stroke and gastrointestinal bleeding. The unique continuous flow produced by various left ventricular assist devices (LVADs) has been suggested as one potential reason for this increased risk of stroke and gastrointestinal bleeding. Furthermore, these continuous-flow (CF) devices challenge our understanding of circulatory blood pressure and flow regulation in relationship to organ health. In healthy pulsatile and dynamic systems, arterial stiffness is a major independent risk factor for stroke. However, to date, there are limited data regarding the impact of CF-LVAD therapy on arterial stiffness. The purpose of this report is to discuss the variable impact of CF-LVAD therapy on arterial stiffness and attempt to highlight some potential mechanisms linking these associations in this unique population.

show abstract

Arterial stiffness, hemodynamics, and microvascular complications in conditions characterized by low arterial pulsatility

McDonnell

Cornwell

Stöhr

2022

Textbook of Arterial Stiffness and Pulsatile Hemodynamics in Health and Disease

View full text Add to dashboard Cite

Increased Aortic Stiffness is Associated with Higher Rates of Stroke, GI-bleeding and Pump Thrombosis in Continuous-Flow Left Ventricular Assist Device Patients

Cited by 4 publications

References 0 publications

Bionic women and men ‐ Part 1: Cardiovascular lessons from heart failure patients implanted with left ventricular assist devices

Bionic women and men ‐ Part 1: Cardiovascular lessons from heart failure patients implanted with left ventricular assist devices

Bionic women and men ‐ Part 2: Arterial stiffness in heart failure patients implanted with left ventricular assist devices

Arterial stiffness, hemodynamics, and microvascular complications in conditions characterized by low arterial pulsatility

Contact Info

Product

Resources

About