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Trans-Aortic Valvular Flow Dynamics And Left Ventricular Ejection Fraction For Monitoring Recovery Of Patients With Left Ventricular Systolic Heart Failure

Siruvallur Vasudevan, V.; Rajagopal, K.; Rame, J. E.; Antaki, J. F.

2023-04-26 cardiovascular medicine
10.1101/2023.04.25.23289129 medRxiv
Show abstract

AO_SCPLOWBSTRACTC_SCPLOWDurable mechanical circulatory support in the form of left ventricular (LV) assist device (LVAD) therapy is increasingly considered in the context of the recovery of native cardiac function. Progressive improvement in LV function may facilitate LVAD explantation and a resultant reduction in device-related risk. However, ascertaining LV recovery remains a challenge. In this study, we investigated the use of trans-aortic valvular flow rate and trans-LVAD flow rate to assess native LV systolic function using a well-established lumped parameter model of the mechanically assisted LV with pre-existing systolic dysfunction. Trans Aortic Valvular Ejection Fraction (TAVEF) was specifically found to characterize the preload-independent contractility of the LV. It demonstrated excellent sensitivity to simulated pharmacodynamic stress tests and volume infusion tests. TAVEF may prove to be useful in the ascertainment of LV recovery in LVAD-supported LVs with pre-existing LV systolic dysfunction.

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