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Functional information about the right ventricle from combined haemodynamic measurements for a right ventricular assist device application

Nannings, L. and Paalvast, O. and Scholten, J. and Dierx, V. (2017) Functional information about the right ventricle from combined haemodynamic measurements for a right ventricular assist device application.

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Abstract:Objectives: Pulmonary hypertension (PH) is a complex, chronic, progressive disease in which a gradual increase in pulmonary vascular resistance (PVR) leads to right ventricular (RV) hypertrophy eventually leading to right heart failure and death. The deployment of a right ventricular assist device (RVAD) is meant to reduce the lethality of this condition, however, application of this requires proper assessment of the volumes and the contractility of the RV. We developed methods to retrieve functional information about the right ventricle from combined haemodynamic measurements for a RVAD application. Methods: Piglets were implanted with catheters and had regular administrations of spheres into their pulmonary circulation in order to induce PH. RV volumes of the piglets were determined using ultra- sound in which the measured area on a 2D ultrasound image was converted to a spherical volume. The RV end-systolic elastance (Ees) was gauged through application of the single beat method in which a theoretical maximum pressure (Pmax) that the RV could generate is estimated. Additional cardiovascular parameters were computed and examined. Results: No significant changes in the end-systolic volumes (ESVs) of the piglets were found. The Pmax, Ea and the Ees showed a significant increase when comparing the very start and very end of the measurement period. Significant increases in pulmonary vascular resistance (PVR) and heart rate (HR) were found as well. Conclusions: Haemodynamic measurements can be used for assessing the RV functionality, but proper data collection and a large sample size are a definite necessity in order to achieve a level at which this assessment suffices for RVAD application. Alternative approaches in determining RV volumes and RV Ees will increase the chance of a successful RVAD application in the future. Keywords: Pulmonary Hypertension, Right Ventricle, Right Ventricular Assist Device, Single Beat Method, PV-loop
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine BSc (50033)
Link to this item:https://purl.utwente.nl/essays/72566
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