TY - JOUR
T1 - Restoration of Pulsatile Flow Reduces Sympathetic Nerve Activity Among Individuals With Continuous-Flow Left Ventricular Assist Devices
AU - Cornwell, William K.
AU - Tarumi Ph.D., Takashi
AU - Stickford, Abigail
AU - Lawley, Justin
AU - Roberts, Monique
AU - Parker, Rosemary
AU - Fitzsimmons, Catherine
AU - Kibe, Julius
AU - Ayers, Colby
AU - Markham, David
AU - Drazner, Mark H
AU - Fu, Qi
AU - Levine, Benjamin D
PY - 2015/10/30
Y1 - 2015/10/30
N2 - BACKGROUND—: Current-generation left ventricular assist devices (LVAD) provide circulatory support that is minimally or entirely nonpulsatile and are associated with marked increases in muscle sympathetic nerve activity (MSNA), likely through a baroreceptor-mediated pathway. We sought to determine whether the restoration of pulsatile flow through modulations in pump speed would reduce MSNA through the arterial baroreceptor reflex. METHODS AND RESULTS—: Ten male and three female subjects (54±14 years) with Heartmate II, continuous-flow (CF) LVADs underwent hemodynamic and sympathetic neural assessment. Beat-to-beat blood pressure, carotid ultrasonography at the level of the arterial baroreceptors and MSNA via microneurography were continuously recorded to determine steady-state responses to step changes (200-400 RPM) in CF-LVAD pump speed from a maximum of 10,480±315 RPM to a minimum of 8,500±380 RPM. Reductions in pump speed led to increases in pulse pressure (high v. low speed: 17±7 v. 26±12mmHg, P
AB - BACKGROUND—: Current-generation left ventricular assist devices (LVAD) provide circulatory support that is minimally or entirely nonpulsatile and are associated with marked increases in muscle sympathetic nerve activity (MSNA), likely through a baroreceptor-mediated pathway. We sought to determine whether the restoration of pulsatile flow through modulations in pump speed would reduce MSNA through the arterial baroreceptor reflex. METHODS AND RESULTS—: Ten male and three female subjects (54±14 years) with Heartmate II, continuous-flow (CF) LVADs underwent hemodynamic and sympathetic neural assessment. Beat-to-beat blood pressure, carotid ultrasonography at the level of the arterial baroreceptors and MSNA via microneurography were continuously recorded to determine steady-state responses to step changes (200-400 RPM) in CF-LVAD pump speed from a maximum of 10,480±315 RPM to a minimum of 8,500±380 RPM. Reductions in pump speed led to increases in pulse pressure (high v. low speed: 17±7 v. 26±12mmHg, P
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U2 - 10.1161/CIRCULATIONAHA.115.017647
DO - 10.1161/CIRCULATIONAHA.115.017647
M3 - Article
C2 - 26510698
AN - SCOPUS:84952630110
SN - 0009-7322
JO - Circulation
JF - Circulation
ER -