Improvement in Biventricular Cardiac Function After Ambulatory Counterpulsation.


Journal

Journal of cardiac failure
ISSN: 1532-8414
Titre abrégé: J Card Fail
Pays: United States
ID NLM: 9442138

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 30 01 2018
revised: 29 10 2018
accepted: 05 11 2018
pubmed: 12 11 2018
medline: 30 6 2019
entrez: 12 11 2018
Statut: ppublish

Résumé

The NupulseCV intravascular ventricular assist system (iVAS), which consists of a durable pump placed through the subclavian artery, provides extended-duration ambulatory counterpulsation. This study investigated the effect of iVAS on biventricular cardiac function. We reviewed all heart failure patients who received iVAS implantation as a bridge to transplantation or a bridge to candidacy since April 2016 as part of the iVAS first-in-humans and subsequent feasibility study. We compared data of transthoracic echocardiography performed just before implantation (without iVAS support) and again at 30 days or just before explantation (on iVAS support). Eighteen patients (58.8 ± 7.4 years old and 15 male) received iVAS support for 53 ± 43 days. Fourteen patients were bridged to cardiac replacement therapy after 35 ± 19 days and the remaining 4 patients had been supported for 118 ± 41 days. There were no deaths during iVAS support. At 30 days, there was a significant improvement in left ventricular ejection fraction (16.5% ± 11.9% vs 24.4% ± 12.8%; P = .007) and marked reduction in left atrial size (62.7 ± 35.7 mL/m Improvement in biventricular cardiac function was observed after 30 days of iVAS support. Further studies should examine the use of this technology as a bridge to recovery.

Sections du résumé

BACKGROUND BACKGROUND
The NupulseCV intravascular ventricular assist system (iVAS), which consists of a durable pump placed through the subclavian artery, provides extended-duration ambulatory counterpulsation. This study investigated the effect of iVAS on biventricular cardiac function.
METHODS AND RESULTS RESULTS
We reviewed all heart failure patients who received iVAS implantation as a bridge to transplantation or a bridge to candidacy since April 2016 as part of the iVAS first-in-humans and subsequent feasibility study. We compared data of transthoracic echocardiography performed just before implantation (without iVAS support) and again at 30 days or just before explantation (on iVAS support). Eighteen patients (58.8 ± 7.4 years old and 15 male) received iVAS support for 53 ± 43 days. Fourteen patients were bridged to cardiac replacement therapy after 35 ± 19 days and the remaining 4 patients had been supported for 118 ± 41 days. There were no deaths during iVAS support. At 30 days, there was a significant improvement in left ventricular ejection fraction (16.5% ± 11.9% vs 24.4% ± 12.8%; P = .007) and marked reduction in left atrial size (62.7 ± 35.7 mL/m
CONCLUSIONS CONCLUSIONS
Improvement in biventricular cardiac function was observed after 30 days of iVAS support. Further studies should examine the use of this technology as a bridge to recovery.

Identifiants

pubmed: 30415014
pii: S1071-9164(18)31177-1
doi: 10.1016/j.cardfail.2018.11.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

20-26

Informations de copyright

Copyright © 2018. Published by Elsevier Inc.

Auteurs

Teruhiko Imamura (T)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Colleen Juricek (C)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

Tae Song (T)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

Takeyoshi Ota (T)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

David Onsager (D)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

Nitasha Sarswat (N)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Gene Kim (G)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Jayant Raikhelkar (J)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Sara Kalantari (S)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Gabriel Sayer (G)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Daniel Burkhoff (D)

Columbia University Medical Center, and Cardiovascular Research Foundation, New York, New York.

Valluvan Jeevanandam (V)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

Nir Uriel (N)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois. Electronic address: nuriel@medicine.bsd.uchicago.edu.

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Classifications MeSH