CrossTalk proposal: Blood flow pulsatility in left ventricular assist device patients is essential to maintain normal brain physiology

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Author
Stöhr, Eric J.
McDonnell, Barry
Colombo, Paolo
Willey, Joshua Z.
Date
2018-12-17Acceptance date
2018-11
Type
Article
Publisher
The Physiological Society
ISSN
0022-3751
1469-7793
Metadata
Show full item recordAbstract
For the first time in history, some humans live without a palpable pulse (Purohit et al. 2018). This remarkable physiology is the consequence of surgical implantation of a continuous‐flow left ventricular assist device (CF‐LVAD) in patients with end‐stage heart failure. Blood flow produced by CF‐LVADs has a low oscillatory profile in the aorta that results in significantly reduced pulsatility in all arterial compartments (Castagna et al. 2017; Fig. 1). Despite remarkable gains in quality of life and longevity, complications that affect not only morbidity, such as gastrointestinal bleeding, but also mortality, such as strokes, are still prevalent in CF‐LVAD patients. Low pulsatility has been proposed as a major culprit in contributing to these adverse events (Mancini & Colombo, 2015; Goldstein et al. 2018). In this CrossTalk proposal, we present the current arguments in favour of maintaining an appropriate amount of arterial pulsatility, in particular in the cerebral circulation, to lower risk in these patients.
Journal/conference proceeding
The Journal of Physiology;
Citation
Stöhr, E.J., McDonnell, B.J., Colombo, P.C. and Willey, J.Z. (2018) 'CrossTalk proposal: Blood flow pulsatility in left ventricular assist device patients is essential to maintain normal brain physiology', The Journal of Physiology. https://doi.org/10.1113/JP276729
Description
Article published in The Journal of Physiology, available at https://doi.org/10.1113/JP276729
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska‐Curie grant agreement No 705219.
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Rebuttal from Eric J. Stöhr, Barry J. McDonnell, Paolo C. Colombo and Joshua Z. Willey
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