Left Ventricular Assist Devices and Other Devices for End-Stage Heart Failure: Utility of Echocardiography

Kirkpatrick, James N.; Wiegers, Susan E.; Lang, Roberto M.

doi:10.1007/s11886-010-0102-0

Cited by 20 publications

(9 citation statements)

References 39 publications

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“…The role of echocardiography is very important in screening, diagnosing, and managing thrombotic events and associated device malfunction. 10,11,88 Further optimization of surface coatings with the aim of achieving better hemocompatibility is needed, as it has been suggested that both thromboembolic and bleeding events could be related to the effects of blood interaction with the device components surface. 18,89,90 Further research in the field and accumulation of clinical experience should provide better understanding of underlying pathophysiology.…”

Section: Resultsmentioning

confidence: 99%

Bleeding and Thrombotic Events in Patients Undergoing Mechanical Circulatory Support: A Review of Literature

Petričević

Miličić

Boban

et al. 2015

Thorac cardiovasc Surg

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Bleeding and thrombotic events are among the most common complications detected in patients with mechanical circulatory support (MCS). Herein, we reviewed the available evidence on the prevalence, etiology, and management of bleeding and thrombotic events in patients following MCS procedures, such as implantation of both intra- and paracorporeal devices that generate either pulsatile or nonpulsatile flow. Extracorporeal life support procedures providing support to the failing heart and lungs were also reviewed. Most bleeding and thromboembolic events occur despite appropriate hemostatic and anticoagulation management based on conventional coagulation laboratory parameters. Prevalence of bleeding events in this population ranges between 5 and 81%. Wide range in prevalence of bleeding reported in literature may be explained by different devices with different anticoagulation protocols being used, as well as different definitions of bleeding outcomes. Although bleeding events are more common than thromboembolic events, the consequences of thrombotic events are often detrimental. Management of bleeding events remains challenging and measures to prevent and treat bleeding events are often followed by thromboembolic events. Therefore, a personalized approach based on point-of-care hemostatic tests and adjusted to device type and patient comorbidities is therefore warranted. To provide advanced understanding of hemostatic disturbances during MCS, prospective trials focused on bleeding and thromboembolic events as primary endpoints should be conducted. Better understanding of the underlying pathophysiology and a shift towards a personalized approach based on functional point-of-care hemostatic properties assessment may provide more favorable clinical outcomes. This should, however, be coupled with further technological improvements providing better device surface hemocompatibility as interaction between blood and device surface affects the hemostatic equilibrium.

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Section: Resultsmentioning

confidence: 99%

Bleeding and Thrombotic Events in Patients Undergoing Mechanical Circulatory Support: A Review of Literature

Petričević

Miličić

Boban

et al. 2015

Thorac cardiovasc Surg

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“…In animal studies, more diverse cell populations have been examined including those derived from pluripotent stem cells. In this section, we review animal studies that satisfy the following criteria: (1) used animal MI model, (2) showed functional cardiac measurements at 4 weeks or longer post cell injection, and (3) injected cells with or without injectable biomaterials. To compare the outcomes from different studies, we investigated 12 parameters focusing on experimental conditions and methods.…”

Section: Direct Cell Injection Strategiesmentioning

confidence: 99%

“…By consequence, cardiac output is reduced, decreasing the ability of the heart to supply blood efficiently. The deterioration of heart function will lead to heart failure, and at the endstages, the only treatment options are heart transplants and ventricular assist devices [1,2]. Therefore, new therapies are required to prevent the progression of pathological remodeling and cell death, as well as to induce tissue recovery in the affected areas.…”

Section: Introductionmentioning

confidence: 99%

Stem Cell-Based Cardiac Tissue Engineering

Nunes

Song

Chiang

et al. 2011

J. of Cardiovasc. Trans. Res.

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Cardiovascular diseases are the leading cause of death worldwide, and cell-based therapies represent a potential cure for patients with cardiac diseases such as myocardial infarction, heart failure, and congenital heart diseases. Towards this goal, cardiac tissue engineering is now being investigated as an approach to support cell-based therapies and enhance their efficacy. This review focuses on the latest research in cardiac tissue engineering based on the use of embryonic, induced pluripotent, or adult stem cells. We describe different strategies such as direct injection of cells and/or biomaterials as well as direct replacement therapies with tissue mimics. In this regard, the latest research has shown promising results demonstrating the improvement of cardiac function with different strategies. It is clear from recent studies that the most important consideration to be addressed by new therapeutic strategies is long-term functional improvement. For this goal to be realized, novel and efficient methods of cell delivery are required that enable high cell retention, followed by electrical integration and mechanical coupling of the injected cells or the engineered tissue to the host myocardium.

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“…The systolic and diastolic function of left ventricle as well as etiology of heart failure may be accurately assessed on echocardiogram. [16][17][18][19][20] Several factors are associated with a poor prognosis in patients of heart failure, widening of QRS complex is one of them which is easily assessed on ECG. This study will help to identify the correlation of AF with wider QRS complex in patients of heart failure with systolic dysfunction (HFrEF) in our population.…”

Section: Introductionmentioning

confidence: 99%

Heart Failure;

Mir

Asghar²,

Javed

2017

TPMJ

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Introduction: Atrial fibrillation (AF) and wider QRS duration have long beenidentified to worsen heart failure and LV dysfunction and increase cardiovascular morbidityand mortality. Therefore, it is necessary to identify those patients of heart failure who are atgreater risk for cardiovascular morbidity and mortality so that such subjects may be focusedfor preventive strategies. An association exists between QRS duration and AF with greaterincidences of cardiovascular events in patients of heart failure with LV systolic dysfunction.Study Design: Cross sectional survey. Setting: Department of Cardiology, Punjab Institute ofCardiology Lahore. Period: 16-02-2015 to 15-08-2015. Material and Methods: The objectiveof study was to determine the Frequency of QRS Duration groups and Atrial Fibrillation inPatients with Left Ventricular Dysfunction. Sample size of 400 cases was calculated with 95%confidence level, 4% margin of error and taking expected percentage of atrial fibrillation innarrow QRS group i.e. 20.9% (least among all) in patients with left ventricular dysfunction.Sampling technique was non-probability, purposive sampling. Result: The study populationconsisted of male (72.3%) and female (27.7%). Mean LA diameter was 40.3±6.08 mm andmean LV ejection fraction 31.8±6.6 % in the study population. Ischemic heart disease wasthe most common cause of LV dysfunction (88.3%) followed by non-ischemic cardiomyopathy(8.75%) and non-Ischemic valvular heart disease (3.5%). The frequency of Narrow QRSd (<120ms) was 62%, Intermediate QRSd (120-150 ms) was 26.5% and Wide QRSd (>150 ms) was11.5%. The frequency of atrial fibrillation in study population was 15.75%. The frequency of atrialfibrillation was highest in Wide QRSd group (>150 ms) i.e. (60.9%), followed by IntermediateQRSd group (120-150 ms) i.e. (18.9%) and narrow QRSd group (<120 ms) i.e. (6.04%). Patientwith atrial fibrillation were more likely to have poor ejection fraction (P<0.0023) and wider QRSduration (P<0.0001). Frequency of atrial fibrillation was highest in Valvular Cardiomyopathy(non-ischemic valvular heart disease) patients (42.8%) as compared to coronary artery diseasegroup (15.3%) and non-ischemic cardimyopathy group (9.4%). Conclusion: In patients of heartfailure with reduced ejection fraction (HFrEF), the frequency of atrial fibrillation increases asQRS duration widens. This group of patients must be focused for AF preventive strategies.

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Left Ventricular Assist Devices and Other Devices for End-Stage Heart Failure: Utility of Echocardiography

Cited by 20 publications

References 39 publications

Bleeding and Thrombotic Events in Patients Undergoing Mechanical Circulatory Support: A Review of Literature

Bleeding and Thrombotic Events in Patients Undergoing Mechanical Circulatory Support: A Review of Literature

Stem Cell-Based Cardiac Tissue Engineering

Heart Failure;

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