Left atrial assist device for heart failure with preserved ejection fraction: initial results with torque control mode in diastolic heart failure model
- 1 May 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Heart Failure Reviews
- Vol. 28 (2), 1-10
- https://doi.org/10.1007/s10741-021-10117-6
Abstract
A novel pump, the left atrial assist device (LAAD), is a device specifically for the treatment of heart failure with preserved ejection fraction (HFpEF). The LAAD is a mixed-flow pump that is implanted in the mitral position and delivers blood from the left atrium to the left ventricle. During the development process, we aimed to explore whether device activation in torque control (TC) mode would improve the function of the LAAD. The TC mode causes adjustment of the pump speed automatically during each cardiac cycle in order to maintain a specified torque. In this study, we tested four different TC settings (TC modes 0.9, 1.0, 1.25, and 1.5) using an in vitro mock circulatory loop. Mild, moderate, and severe diastolic heart failure (DHF) conditions, as well as normal heart condition, were simulated with the four TC modes. Also, we evaluated the LAAD in vivo with three calves. The LAAD was implanted at the mitral position with four TC settings (TC modes 0.9, 1.0, 1.1, 1.2). With LAAD support, the in vitro cardiac output and aortic pressure recovered to normal heart levels at TC 1.25 and 1.5 even under severe DHF conditions with little pump regurgitation. The TC mode tested in vivo with three calves, and it also showed favorable result without elevating the left ventricular end-diastolic pressure. These initial in vitro and in vivo results suggest that the TC mode could be potentially effective, and the LAAD could be a treatment option for HFpEF patients.Keywords
This publication has 36 references indexed in Scilit:
- Positive effect of dapagliflozin on left ventricular longitudinal function for type 2 diabetic mellitus patients with chronic heart failureCardiovascular Diabetology, 2020
- Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection FractionThe New England Journal of Medicine, 2019
- Heart failure with preserved ejection fraction: from mechanisms to therapiesEuropean Heart Journal, 2018
- Potential impact of SGLT2 inhibitors on left ventricular diastolic function in patients with diabetes mellitusHeart Failure Reviews, 2018
- 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failureEuropean Heart Journal, 2016
- Angiotensin–Neprilysin Inhibition versus Enalapril in Heart FailureThe New England Journal of Medicine, 2014
- Spironolactone for Heart Failure with Preserved Ejection FractionThe New England Journal of Medicine, 2014
- 2013 ACCF/AHA Guideline for the Management of Heart FailureJournal of Invasive Cardiology, 2013
- Characterization of health‐related quality of life in heart failure patients with preserved versus low ejection fraction in CHARMEuropean Journal of Heart Failure, 2007
- Outcome of Heart Failure with Preserved Ejection Fraction in a Population-Based StudyThe New England Journal of Medicine, 2006