Journal article
Impact of left ventricular assist device speed adjustment on exercise tolerance and markers of wall stress
International Journal of Artificial Organs, Vol.38(9), pp.501-507
2015
PMID: 26391365
Abstract
Introduction: Left ventricular assist devices are crucial in rehabilitation of patients with end-stage heart failure. Whether cardiopulmonary function is enhanced with higher pump output is unknown.
Methods: 10 patients (aged 39 ± 16 years, mean ± SD) underwent monitored adjustment of pump speed to determine minimum safe low speed and maximum safe high speed at rest. Patients were then randomized to these speed settings and underwent three 6-minute walk tests (6MWT) and symptom-limited cardiopulmonary stress tests (CPX) on separate days.
Results: Pump speed settings (low, normal and high) resulted in significantly different resting pump flows of 4.43 ± 0.6, 5.03 ± 0.94, and 5.72 ± 1.2 l/min (P<.001). There was a significant enhancement of pump flows (greater at higher speed settings) with exercise (P<0.05). Increased pump speed was associated with a trend to increased 6MWT distance (P = .10); and CPX exercise time (p = .27). Maximum workload achieved and peak oxygen consumption were significantly different comparing low to high pump speed settings only (P<.05). N-terminal-pro-B-type natriuretic peptide release was significantly reduced at higher pump speed with exercise (P<.01).
Conclusions: We have found that alteration of pump speed setting resulted in significant variation in estimated pump flow. The high-speed setting was associated with lower natriuretic hormone release consistent with lower myocardial wall stress. This did not, however, improve exercise tolerance
Details
- Title
- Impact of left ventricular assist device speed adjustment on exercise tolerance and markers of wall stress
- Authors
- Christopher S Hayward (Author) - Victor Chang Cardiac Research Institute, Sydney - AustraliaRobert Salamonsen (Author) - The Alfred Hospital, Melbourne - AustraliaAnne M Keogh (Author) - Victor Chang Cardiac Research Institute, Sydney - AustraliaJohn Woodard (Author) - Berlin Heart, Berlin - GermanyPeter Ayre (Author) - Thorvascular Pty Ltd, Crows Nest, Sydney - AustraliaRoslyn Prichard (Author) - St. Vincent's Hospital, Sydney - AustraliaEugene Kotlyar (Author) - St. Vincent's Hospital, Sydney - AustraliaPeter S Macdonald (Author) - Victor Chang Cardiac Research Institute, Sydney - AustraliaPaul Jansz (Author) - St. Vincent's Hospital, Sydney - AustraliaPhillip Spratt (Author) - St. Vincent's Hospital, Sydney - Australia
- Publication details
- International Journal of Artificial Organs, Vol.38(9), pp.501-507
- Publisher
- Sage Publications Ltd.
- DOI
- 10.5301/ijao.5000431
- ISSN
- 1724-6040
- PMID
- 26391365
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy; School of Health - Nursing
- Language
- English
- Record Identifier
- 99512808102621
- Output Type
- Journal article
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- Domestic collaboration
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- Engineering, Biomedical
- Transplantation
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