The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities
Stöhr, Eric J.
Cockcroft, John R.
Reshad Garan, A.
Topkara, Veli K.
Colombo, Paolo C.
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An increasing number of end-stage heart failure patients are now implanted with continuous-flow left ventricular assist devices (CF-LVADs). Although this therapeutic approach is associated with improved clinical outcomes, continuous flow physiology reduces arterial pulse pressure and pulsatility to an extent that is unique to this population. Recent data suggest that high blood pressure (BP) contributes to life-threatening complications such as pump thrombosis and stroke of CF-LVAD patients. However, limited understanding of the distinct hemodynamics of these pumps makes measurement and, consequently, medical management of BP quite challenging. Here, we review the evolution of LVAD design, the impact of CF-LVAD flow, and “artificial pulse” technology on hemodynamics and BP measurement, as well as suggest new approaches for the assessment and interpretation of the unique physiology of modern LVADs.
Current Hypertension Reports;
Castagna, F., Stöhr, E.J., Pinsino, A., Cockcroft, J.R., Willey, J., Reshad Garan, A., Topkara, V.K., Colombo, P.C., Yuzefpolskaya, M. and McDonnell, B.J. (2017) 'The Unique Blood Pressures and Pulsatility of LVAD Patients: Current Challenges and Future Opportunities', Current Hypertension Reports, DOI 10.1007/s11906-017-0782-6
This article was published in Current Hypertension Reports on 18 October 2017 (online), available at https://doi.org/10.1007/s11906-017-0782-6