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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Bionic women and men part 4-cardiovascular, cerebrovascular and exercise responses among patients supported with left ventricular assist devices
Experimental physiology, v 105(5), pp 763-766
01 May 2020
PMID: 32105385
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
New Findings
LVAD patients are predisposed to hypertension which may increase the risk of stroke. Hypertension may result from markedly elevated levels of sympathetic nerve activity, which occurs through a baroreceptor-mediated pathway in response to chronic exposure to a non-physiologic (and reduced) pulse.
Cerebral autoregulatory processes appear to be preserved in the absence of a physiologic pulse. Nevertheless, the rate of ischemic/embolic and hemorrhagic stroke is unacceptably high and is a major cause of morbidity and mortality in these patients.
Despite normalization of a resting cardiac output, LVAD patients suffer from persistent, severe reductions in functional capacity.
Current generation left ventricular assist devices (LVADs) have led to significant improvements in survival compared to medical therapy alone, when used for management of patients with advanced heart failure. However, there are a number of side-effects associated with LVAD use, including hypertension, gastrointestinal bleeding, stroke, as well as persistent and severe limitations in functional capacity despite normalization of a resting cardiac output. These issues are, in large part, related to chronic exposure to a non-physiologic pulse, which contributes to a hyperadrenergic environment characterized by markedly elevated levels of sympathetic nerve activity through a baroreceptor-mediated pathway. In addition, these machines are unable to participate in, or contribute to, normal cardiovascular/autonomic reflexes that attempt to modulate flow through the body. Efforts to advance device technology and develop biologically sensitive devices may resolve these issues, and lead to further improvements in quality-of-life, functional capacity, and ultimately, survival, for the patients they support.
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Details
- Title
- Bionic women and men part 4-cardiovascular, cerebrovascular and exercise responses among patients supported with left ventricular assist devices
- Creators
- Cullen Buchanan - University of Colorado Anschutz Medical CampusManreet Kanwar - Allegheny Health NetworkJohn R. Cockcroft - Cardiff Metropolitan UniversityBarry McDonnell - Cardiff Metropolitan UniversityEric J. Stohr - Cardiff Metropolitan UniversityWilliam K. Cornwell - University of Colorado Anschutz Medical Campus
- Publication Details
- Experimental physiology, v 105(5), pp 763-766
- Publisher
- Wiley
- Number of pages
- 4
- Grant note
- Medtronic NIH/NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Marie Sklodowska-Curie Grant Abbott Inc; Abbott Laboratories
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:000520296400001
- Scopus ID
- 2-s2.0-85082412757
- Other Identifier
- 991021932189604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Physiology