Restoration of Pulsatile Flow Reduces Sympathetic Nerve Activity Among Individuals With Continuous-Flow Left Ventricular Assist Devices

William K. Cornwell, Takashi Tarumi Ph.D., Abigail Stickford, Justin Lawley, Monique Roberts, Rosemary Parker, Catherine Fitzsimmons, Julius Kibe, Colby Ayers, David Markham, Mark H Drazner, Qi Fu, Benjamin D Levine

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

BACKGROUND—: Current-generation left ventricular assist devices (LVAD) provide circulatory support that is minimally or entirely nonpulsatile and are associated with marked increases in muscle sympathetic nerve activity (MSNA), likely through a baroreceptor-mediated pathway. We sought to determine whether the restoration of pulsatile flow through modulations in pump speed would reduce MSNA through the arterial baroreceptor reflex. METHODS AND RESULTS—: Ten male and three female subjects (54±14 years) with Heartmate II, continuous-flow (CF) LVADs underwent hemodynamic and sympathetic neural assessment. Beat-to-beat blood pressure, carotid ultrasonography at the level of the arterial baroreceptors and MSNA via microneurography were continuously recorded to determine steady-state responses to step changes (200-400 RPM) in CF-LVAD pump speed from a maximum of 10,480±315 RPM to a minimum of 8,500±380 RPM. Reductions in pump speed led to increases in pulse pressure (high v. low speed: 17±7 v. 26±12mmHg, P

Original languageEnglish (US)
JournalCirculation
DOIs
StateAccepted/In press - Oct 30 2015

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

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    Cornwell, W. K., Tarumi Ph.D., T., Stickford, A., Lawley, J., Roberts, M., Parker, R., Fitzsimmons, C., Kibe, J., Ayers, C., Markham, D., Drazner, M. H., Fu, Q., & Levine, B. D. (Accepted/In press). Restoration of Pulsatile Flow Reduces Sympathetic Nerve Activity Among Individuals With Continuous-Flow Left Ventricular Assist Devices. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.115.017647