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Relation between pressure and volume unloading during ramp testing in patients supported with a continuous-flow left ventricular assist device.

Publication ,  Journal Article
Jung, MH; Hassager, C; Balling, L; Russell, SD; Boesgaard, S; Gustafsson, F
Published in: ASAIO J
2015

Pulmonary capillary wedge pressure (PCWP) is the key to describing left ventricular (LV) unloading; however, the relation between pressure and the echocardiography-derived surrogate of LV volume (LV end-diastolic diameter [LVEDD]) as a function of pump speed (revolutions per minute [RPM]) in continuous-flow LV assist device (CF-LVAD) patients is unknown. In this study, the pressure-volume relation as a function of RPM during ramp testing was investigated by simultaneously measuring PCWP by Swan-Ganz catheter and LVEDD by echocardiography. The ramp protocol started at usual pump setting (ramp-base) and then went from 8,000 RPM (ramp-low) increasing by 400 RPM/5 minutes until reaching 12,000 RPM or suction/arrhythmic event (ramp-high). The study was finalized by a 25 Watt exercise test at two ramp steps. Ten patients with ramp-base of 9,300 ± 241 RPM (at which 3 of 10 had aortic valve opening) were examined. At ramp-low, ramp-base, and ramp-high, PCWP was 20 ± 4, 14 ± 4, and 7 ± 3 mm Hg (p < 0.001 for all comparisons) and LVEDD 6.6 ± 1.0, 6.7 ± 0.9, and 5.5 ± 1.7 cm (p < 0.05 for all comparisons but ramp-low versus ramp-base). Correlation between PCWP and LVEDD slopes; R = 0.53 (p = 0.02). In conclusion, PCWP as a function of RPM is weakly correlated with changes in LVEDD. Thus, LVEDD is not an accurate measure of unloading in CF-LVAD patients.

Duke Scholars

Published In

ASAIO J

DOI

EISSN

1538-943X

Publication Date

2015

Volume

61

Issue

3

Start / End Page

307 / 312

Location

United States

Related Subject Headings

  • Pulmonary Wedge Pressure
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Ventricles
  • Heart Failure
  • Female
  • Echocardiography
  • Biomedical Engineering
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Jung, M. H., Hassager, C., Balling, L., Russell, S. D., Boesgaard, S., & Gustafsson, F. (2015). Relation between pressure and volume unloading during ramp testing in patients supported with a continuous-flow left ventricular assist device. ASAIO J, 61(3), 307–312. https://doi.org/10.1097/MAT.0000000000000194
Jung, Mette H., Christian Hassager, Louise Balling, Stuart D. Russell, Soeren Boesgaard, and Finn Gustafsson. “Relation between pressure and volume unloading during ramp testing in patients supported with a continuous-flow left ventricular assist device.ASAIO J 61, no. 3 (2015): 307–12. https://doi.org/10.1097/MAT.0000000000000194.
Jung MH, Hassager C, Balling L, Russell SD, Boesgaard S, Gustafsson F. Relation between pressure and volume unloading during ramp testing in patients supported with a continuous-flow left ventricular assist device. ASAIO J. 2015;61(3):307–12.
Jung, Mette H., et al. “Relation between pressure and volume unloading during ramp testing in patients supported with a continuous-flow left ventricular assist device.ASAIO J, vol. 61, no. 3, 2015, pp. 307–12. Pubmed, doi:10.1097/MAT.0000000000000194.
Jung MH, Hassager C, Balling L, Russell SD, Boesgaard S, Gustafsson F. Relation between pressure and volume unloading during ramp testing in patients supported with a continuous-flow left ventricular assist device. ASAIO J. 2015;61(3):307–312.

Published In

ASAIO J

DOI

EISSN

1538-943X

Publication Date

2015

Volume

61

Issue

3

Start / End Page

307 / 312

Location

United States

Related Subject Headings

  • Pulmonary Wedge Pressure
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Ventricles
  • Heart Failure
  • Female
  • Echocardiography
  • Biomedical Engineering