An in silico study of the effects of left ventricular assist device on right ventricular function and inter-ventricular interaction

Lei Fan, Jenny S. Choy, Sangjin Lee, Kenneth Campbell, Jonathan F. Wenk, Ghassan S. Kassab, Daniel Burkhoff, Lik Chuan Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Left ventricular assist device (LVAD) is associated with a high incidence of right ventricular (RV) failure, which is hypothesized to be caused by the occurring inter-ventricular interactions when the LV is unloaded. Factors contributing to these interactions are unknown. Methods: We used computer modeling to investigate the impact of the HeartMate 3 LVAD on RV functions. The model was first calibrated against pressure–volume (PV) loops associated with a heart failure (HF) patient and validated against measurements of inter-ventricular interactions in animal experiments. The model was then applied to investigate the effects of LVAD on (1) RV chamber contractility indexed by (Formula presented.) derived from its end-systolic PV relationship, and (2) RV diastolic function indexed by (Formula presented.) derived from its end-diastolic PV relationship. We also investigated how septal wall thickness and regional contractility affect the impact of LVAD on RV function. Results: The impact of LVAD on RV chamber contractility is small at a pump speed lower than 4k rpm. At a higher pump speed between 4k and 9k rpm, however, RV chamber contractility is reduced (by ~3% at 6k rpm and ~10% at 9k rpm). The reduction of RV chamber contractility is greater with a thinner septal wall or with a lower myocardial contractility at the LV free wall, septum, or RV free wall. Conclusion: RV chamber contractility is reduced at a pump speed higher than 4k rpm, and this reduction is greater with a thinner septal wall or lower regional myocardial contractility. Findings here may have clinical implications in identifying LVAD patients who may suffer from RV failure.

Original languageEnglish
JournalArtificial Organs
DOIs
StateAccepted/In press - 2023

Bibliographical note

Publisher Copyright:
© 2023 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.

Keywords

  • computational modeling
  • inter-ventricular interactions
  • LVAD
  • right ventricular failure

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

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