Interventricular dyssynchrony during continuous-flow left ventricular assist device support

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K18201
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55030:Cardiovascular surgery-related
• Research Institution: National Cardiovascular Center Research Institute
• Principal Investigator: Shimamura Junichi 国立研究開発法人国立循環器病研究センター, 研究所, 客員研究員 (20827696)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 左室補助人工心臓 / 重症心不全 / 同期不全 / 右心不全

Outline of Final Research Achievements

Under continuous-flow left ventricular assist device (CF-LVAD) support, the ventricular volume change and cardiac cycle between the left ventricle (LV) and right ventricle (RV) become dyssynchronous due to the shortening of the LV systole.The purpose of this study was to quantify interventricular dyssynchrony based on different CF-LVAD support conditions and assess its relationship with LV unloading. We implanted a centrifugal LVAD under general anesthesia to goats with normal hearts. We inserted the conductance catheters into LV and RV to assess the volume signal simultaneously. We defined the dyssynchronous (DYS)status as the sign of the LV volume-change opposite to that of RV volume-change. DYS was quantified and also found to be associated with the degree of LV unloading. These findings may be useful for understanding interventricular interactions and physiology during CF-LVAD support. Influences on the right ventricular function and heart failure models warrant further study.

Free Research Field

心臓血管外科

Academic Significance and Societal Importance of the Research Achievements

本研究は左室補助人工心臓駆動時の機械的心室間同期不全の機序および心室間相互作用に及ぼす影響に関して検討したものである。左室補助人工心臓装着後の主要合併症である右心不全の詳細な機序は依然解明されていないが、本現象は重症心不全患者に合併する同期不全の増悪や、心室中隔運動への影響を介して右心機能への影響をもたらす重要な一因と考えられる。適切な左室補助人工心臓駆動により同現象を制御することは、右室機能不全改善に有用であることが示唆される。以上より、本研究で得られる知見は左室補助人工心臓駆動に伴う心室間相互作用の理解に役立ち、安全でより生理的な左室補助人工心臓駆動方法の開発に寄与するものである。