Worsening Renal Function in Cardiac Mechanical Support

Tsay, Julie; Pinkhas, Daniel; Lee, Bryan C.; Guo, Aaron; Ferrall, Joel; Derbala, Mohamed H.; Lampert, Brent C.; Emani, Sitaramesh; Whitson, Bryan A.; Smith, Sakima A.

doi:10.1016/j.hlc.2019.11.011

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…The effect of CAD on renal pathology is complex and not yet well understood. 133 An MCL could be used as a tool to understand the haemodynamics of the renal circulation. Furthermore, the brain responds to an increase in carbon dioxide or hydrogen ions, which causes dilation in the cerebral vessels, allowing the waste products to wash out.…”

Section: Discussionmentioning

confidence: 99%

Mock circulatory loops used for testing cardiac assist devices: A review of computational and experimental models

Cappon

Papaioannou

et al. 2021

Int J Artif Organs

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Heart failure is a major health risk, and with limited availability of donor organs, there is an increasing need for developing cardiac assist devices (CADs). Mock circulatory loops (MCL) are an important in-vitro test platform for CAD’s performance assessment and optimisation. The MCL is a lumped parameter model constructed out of hydraulic and mechanical components aiming to simulate the native cardiovascular system (CVS) as closely as possible. Further development merged MCLs and numerical circulatory models to improve flexibility and accuracy of the system; commonly known as hybrid MCLs. A total of 128 MCLs were identified in a literature research until 25 September 2020. It was found that the complexity of the MCLs rose over the years, recent MCLs are not only capable of mimicking the healthy and pathological conditions, but also implemented cerebral, renal and coronary circulations and autoregulatory responses. Moreover, the development of anatomical models made flow visualisation studies possible. Mechanical MCLs showed excellent controllability and repeatability, however, often the CVS was overly simplified or lacked autoregulatory responses. In numerical MCLs the CVS is represented with a higher order of lumped parameters compared to mechanical test rigs, however, complex physiological aspects are often simplified. In hybrid MCLs complex physiological aspects are implemented in the hydraulic part of the system, whilst the numerical model represents parts of the CVS that are too difficult to represent by mechanical components per se. This review aims to describe the advances, limitations and future directions of the three types of MCLs.

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Section: Discussionmentioning

confidence: 99%

Mock circulatory loops used for testing cardiac assist devices: A review of computational and experimental models

Cappon

Papaioannou

et al. 2021

Int J Artif Organs

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“…There are several pathways in the setting of heart failure that contribute to a decline in the eGFR. Central venous congestion developed in HF was demonstrated to induce elevated interstitial pressure which subsequently resulted in decreased GFR [26]. In addition, long term treatment with diuretic may further exacerbate the renal function deterioration by reducing kidney blood flow [27].…”

Section: Discussionmentioning

confidence: 99%

Plasma trimethylamine n-oxide is associated with renal function in patients with heart failure with preserved ejection fraction

Guo

Qiu

Tan

et al. 2020

BMC Cardiovasc Disord

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Background: Heart failure with preserved ejection fraction (HFpEF) is an emerging global health problem with less awareness. Renal dysfunction in HFpEF is associated with worse outcome. However, there is lack of rapid, noninvasive and accurate method for risk stratification in HFpEF and renal dysfunction. This study aimed to explore the utility of plasma trimethylamine n-oxide (TMAO) for evaluation of HFpEF and renal function. Methods: Plasma TMAO levels were measured in total 324 subjects comprising 228 HFpEF patients and 96 healthy controls. Results: TMAO levels were significantly elevated in patients with HFpEF compared with controls (12.65(9.32-18.66) μg/l vs 10.85(6.35-15.58) μg/l, p < 0.01). Subjects in higher TMAO tertile group had more incidences of HFpEF ((78.5%) in tertile 3 vs (73.39%) in tertile 2 vs (59.26%) in tertile 1, p < 0.01). TMAO concentrations were inversely correlated with estimated glomerular filtration rate (eGFR) and HFpEF patients with impaired renal function (eGFR < 60 ml/min/1.73 m 2) had higher TMAO than those with normal eGFR (≥ 60 ml/min/1.73 m 2) (14.18(10.4-23.06) μg/l vs 10.9(7.48-15.47) μg/l, p < 0.01). Increased TMAO levels were independently associated with higher risk of HFpEF (OR = 3.49, 95% CI: 1.23-9.86, p = 0.02) and renal dysfunction (OR = 9.57, 95% CI: 2.11-43.34, p < 0.01) after adjustment for multiple traditional risk factors. Furthermore, TMAO had good performance at distinguishing HFpEF from controls (AUC = 0.63, p < 0.01), and renal dysfunction from normal renal function in HFpEF (AUC = 0.67, p < 0.01). Conclusion: In this cross-sectional study, HFpEF and renal function were closely related with plasma TMAO levels and TMAO may serve as a diagnostic biomarker for HFpEF and renal function.

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Mean Perfusion Pressure and Venous Congestion: Important but Often Forgotten Aspects of Heart Failure

Raman,

Hu,

Bellomo

2024

Heart, Lung and Circulation

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Worsening Renal Function in Cardiac Mechanical Support

Cited by 4 publications

References 19 publications

Mock circulatory loops used for testing cardiac assist devices: A review of computational and experimental models

Mock circulatory loops used for testing cardiac assist devices: A review of computational and experimental models

Plasma trimethylamine n-oxide is associated with renal function in patients with heart failure with preserved ejection fraction

Mean Perfusion Pressure and Venous Congestion: Important but Often Forgotten Aspects of Heart Failure

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