Journal article
Impact of Interventricular Interaction on Ventricular Function
JACC. Heart failure, v 12(7), pp 1179-1192
Jul 2024
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Interventricular interactions may be responsible for the decline in ventricular performance observed in various disease states that primarily affect the contralateral ventricle.
This study sought to quantify the impact of such interactions on right ventricular (RV) size and function using clinically stable individuals with left ventricular assist devices (LVADs) as a model for assessing RV hemodynamics while LV loading conditions were acutely manipulated by changing device speed during hemodynamic optimization studies (ie, ramp tests).
The investigators recorded RV pressure-volume loops with a conductance catheter at various speeds during ramp tests in 20 clinically stable HeartMate3 recipients.
With faster LVAD speeds and greater LV unloading, indexed RV end-diastolic volume increased (72.28 ± 15.07 mL at low speed vs 75.95 ± 16.90 at high speed; P = 0.04) whereas indexed end-systolic volumes remained neutral. This resulted in larger RV stroke volumes and shallower end-diastolic pressure-volume relationships. Concurrently, RV end-systolic pressure decreased (31.58 ± 9.75 mL at low speed vs 29.58 ± 9.41 mL at high speed; P = 0.02), but contractility, as measured by end-systolic elastance, did not change significantly. The reduction in RV end-systolic pressure was associated with a reduction in effective arterial elastance from 0.65 ± 0.43 mm Hg/mL at low speed to 0.54 ± 0.33 mm Hg/mL at high speed (P = 0.02).
Interventricular interactions resulted in improved RV compliance, diminished afterload, and did not reduce RV contractility. These data challenge the prevailing view that interventricular interactions compromise RV function, which has important implications for the understanding of RV-LV interactions in various disease states, including post-LVAD RV dysfunction.
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Details
- Title
- Impact of Interventricular Interaction on Ventricular Function
- Creators
- Michael I. Brener - Columbia University Irving Medical CenterManreet K. Kanwar - Allegheny Health NetworkMatthew M. Lander - Allegheny Health NetworkNadira B. Hamid - Minneapolis Heart Institute FoundationAmresh Raina - Allegheny Health NetworkSanjum S. Sethi - NewYork–Presbyterian HospitalMatthew T. Finn - NewYork–Presbyterian HospitalJustin A. Fried - NewYork–Presbyterian HospitalJayant Raikhelkar - NewYork–Presbyterian HospitalAmirali Masoumi - Morristown Medical CenterHannah R. Rosenblum - NewYork–Presbyterian HospitalMathew S. Maurer - Columbia University Irving Medical CenterGabriel Sayer - NewYork–Presbyterian HospitalDaniel Burkhoff - Columbia University Irving Medical CenterNir Uriel - Columbia University Irving Medical Center
- Publication Details
- JACC. Heart failure, v 12(7), pp 1179-1192
- Publisher
- Elsevier; London
- Number of pages
- 14
- Grant note
- National Institutes of Health: HL139671-01AL 1, AG K24AG036778
This project was supported, in part, by the American College of Cardiology and Merck Research Fellowship Award. Dr Brener hasreceived consulting fees from Artract Medical and Osprey Medical. Dr Kanwar has served on the Medical Advisory Boards of Abiomed, CareDx, and CorWave. Dr Lander has served on the Medical Advisory Board of Abiomed. Dr Raina has received research support from United Therapeutics and Merck. Dr Sethi has received honoraria from Janssen and Chiessi; and has received institutional grant support from the American Heart Association 's COVID-19 Rapid Response Award. Dr Maurer has received funding from the National Institutes of Health (HL139671-01AL1 and AG K24AG036778) ; AD consulting income from Ionis, Alnylam, Eidos Therapeutics, P fizer, Intellia, and Prothena; and his institution has also received funding for clinical trials for Ionis, Alnylam, Eidos Therapeutics, Pfizer, and Attralus. Dr Sayer has received consulting fees from Abbott. Dr Burkhoff has received an unrestricted institutional educational grant from Abiomed. Dr Uriel has received grant support from Abbott, Abiomed, and Fire1; and has served on the Medical Advisory Boards of Leviticus and Revamp. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.r received consulting fees from Artract Medical and Osprey Medical. Dr Kanwar has served on the Medical Advisory Boards of Abiomed, CareDx, and CorWave. Dr Lander has served on the Medical Advisory Board of Abiomed. Dr Raina has received research support from United Therapeutics and Merck. Dr Sethi has received honoraria from Janssen and Chiessi; and has received institutional grant support from the American Heart Association 's COVID-19 Rapid Response Award. Dr Maurer has received funding from the National Institutes of Health (HL139671-01AL 1 and AG K24AG036778) ; AD consulting in-come from Ionis, Alnylam, Eidos Therapeutics, P fizer, Intellia, and Prothena; and his institution has also received funding for clinical trials for Ionis, Alnylam, Eidos Therapeutics, P fizer, and Attralus. Dr Sayer has received consulting fees from Abbott. Dr Burkhoff has received an unrestricted institutional educational grant from Abiomed. Dr Uriel has received grant support from Abbott, Abiomed, and Fire1; and has served on the Medical Advisory Boards of Leviticus and Revamp. All other authors have reported that they have no re-lationships relevant to the contents of this paper to disclose.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); Cardiology
- Web of Science ID
- WOS:001263509200001
- Scopus ID
- 2-s2.0-85186072732
- Other Identifier
- 991021932106704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems