Differential Effects of Pharmacologic and Mechanical Support on Right-Left Ventricular Coupling
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12265_2024_10522_ReferencePDF.pdf
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Author(s)
Lamberti, Kimberly K.
Goffer, Efrat M.
Edelman, Elazer R.
Keller, Steven P.
Date Issued
May 20, 2024
Journal
Journal of Cardiovascular Translational Research
Publisher
Springer US
Citation
Lamberti, K.K., Goffer, E.M., Edelman, E.R. et al. Differential Effects of Pharmacologic and Mechanical Support on Right-Left Ventricular Coupling. J. of Cardiovasc. Trans. Res. 17, 1181–1192 (2024).
Version
Author's final manuscript
Abstract
Background Percutaneous ventricular assist devices are increasingly relied on to maintain perfusion for cardiogenic shock patients. Optimal medical management strategies however remain uncertain from limited understanding of interventricular effects. This study analyzed the effects of pharmacologic and left-sided mechanical support on right ventricular function. Methods A porcine model was developed to assess biventricular function during bolus pharmacologic administration before and after left-sided percutaneous ventricular assist and in cardiogenic shock. Results The presence of mechanical support increased right ventricular load and stress with respect to the left ventricle. This shifted and exaggerated the relative effects of commonly used vasoactive agents. Furthermore, induction of cardiogenic shock led to differential pulmonary vascular and right ventricular responses. Conclusions Left ventricular ischemia and mechanical support altered interventricular coupling. Resulting impacts of pharmacologic agents indicate differential right heart responses and sensitivity to treatments and the need for further study to optimize biventricular function in shock patients. Graphical Abstract
MIT Department
Institute for Medical Engineering and Science
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Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
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DOI of Published Version
https://doi.org/10.1007/s12265-024-10522-w
