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The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD

Heart failure remains a significant cause of mortality in the United States and around the world. While organ transplantation is acknowledged as the gold standard treatment for end stage heart failure, supply is limited, and many patients are treated with left ventricular assist devices (LVADs). LVA...

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Autores principales: Wilson, Shannon I., Ingram, Katelyn E., Oh, Albert, Moreno, Michael R., Kassi, Mahwash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484111/
https://www.ncbi.nlm.nih.gov/pubmed/37692033
http://dx.doi.org/10.3389/fcvm.2023.1248300
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author Wilson, Shannon I.
Ingram, Katelyn E.
Oh, Albert
Moreno, Michael R.
Kassi, Mahwash
author_facet Wilson, Shannon I.
Ingram, Katelyn E.
Oh, Albert
Moreno, Michael R.
Kassi, Mahwash
author_sort Wilson, Shannon I.
collection PubMed
description Heart failure remains a significant cause of mortality in the United States and around the world. While organ transplantation is acknowledged as the gold standard treatment for end stage heart failure, supply is limited, and many patients are treated with left ventricular assist devices (LVADs). LVADs extend and improve patients' lives, but they are not without their own complications, particularly the hemocompatibility related adverse events (HRAE) including stroke, bleeding and pump thrombosis. Mainstream imaging techniques currently in use to assess appropriate device function and troubleshoot complications, such as echocardiography and cardiac computed tomography, provide some insight but do not provide a holistic understanding of pump induced flow alterations that leads to HRAEs. In contrast, there are technologies restricted to the benchtop—such as computational fluid dynamics and mock circulatory loops paired with methods like particle image velocimetry—that can assess flow metrics but have not been optimized for clinical care. In this review, we outline the potential role and current limitations of converging available technologies to produce novel imaging techniques, and the potential utility in evaluating hemodynamic flow to determine whether LVAD patients may be at higher risk of HRAEs. This addition to diagnostic and monitoring capabilities could improve prevention and treatment of LVAD-induced complications in heart failure patients.
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spelling pubmed-104841112023-09-08 The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD Wilson, Shannon I. Ingram, Katelyn E. Oh, Albert Moreno, Michael R. Kassi, Mahwash Front Cardiovasc Med Cardiovascular Medicine Heart failure remains a significant cause of mortality in the United States and around the world. While organ transplantation is acknowledged as the gold standard treatment for end stage heart failure, supply is limited, and many patients are treated with left ventricular assist devices (LVADs). LVADs extend and improve patients' lives, but they are not without their own complications, particularly the hemocompatibility related adverse events (HRAE) including stroke, bleeding and pump thrombosis. Mainstream imaging techniques currently in use to assess appropriate device function and troubleshoot complications, such as echocardiography and cardiac computed tomography, provide some insight but do not provide a holistic understanding of pump induced flow alterations that leads to HRAEs. In contrast, there are technologies restricted to the benchtop—such as computational fluid dynamics and mock circulatory loops paired with methods like particle image velocimetry—that can assess flow metrics but have not been optimized for clinical care. In this review, we outline the potential role and current limitations of converging available technologies to produce novel imaging techniques, and the potential utility in evaluating hemodynamic flow to determine whether LVAD patients may be at higher risk of HRAEs. This addition to diagnostic and monitoring capabilities could improve prevention and treatment of LVAD-induced complications in heart failure patients. Frontiers Media S.A. 2023-08-24 /pmc/articles/PMC10484111/ /pubmed/37692033 http://dx.doi.org/10.3389/fcvm.2023.1248300 Text en © 2023 Wilson, Ingram, Oh, Moreno and Kassi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Wilson, Shannon I.
Ingram, Katelyn E.
Oh, Albert
Moreno, Michael R.
Kassi, Mahwash
The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD
title The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD
title_full The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD
title_fullStr The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD
title_full_unstemmed The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD
title_short The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD
title_sort role of innovative modeling and imaging techniques in improving outcomes in patients with lvad
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10484111/
https://www.ncbi.nlm.nih.gov/pubmed/37692033
http://dx.doi.org/10.3389/fcvm.2023.1248300
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