Effect of pump flow mode of novel left ventricular assist device upon end organ perfusion in dogs with doxorubicin induced heart failure

ASAIO J. Jan-Feb 2005;51(1):41-9. doi: 10.1097/01.mat.0000150510.03339.ad.

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.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Aorta / physiology
  • Aorta, Thoracic / physiology
  • Blood Pressure / physiology
  • Counterpulsation*
  • Dogs
  • Doxorubicin
  • Heart Failure / chemically induced*
  • Heart Failure / diagnostic imaging
  • Heart Failure / pathology
  • Heart-Assist Devices*
  • Hemodynamics
  • Myocardium / ultrastructure
  • Perfusion
  • Pulsatile Flow*
  • Ultrasonography
  • Ventricular Function, Left / physiology*

Substances

  • Doxorubicin