Identifying and Facilitating Ventricular Recovery on Mechanical Support

识别并促进机械支持下的心室恢复

基本信息

批准号：
7494635
负责人：
JOHN GORCSAN
金额：
$ 63.93万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-15 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7494635
关键词：
Academic Medical Centers Address Adjuvant Therapy Affect Algorithms Animal Experiments Animal Model Animals Arrhythmia Artificial Heart Assisted Circulation Biomechanics Biomedical Engineering Cardiac Cardiac Catheterization Procedures Cardiac Surgery procedures Cardiology Caring Catheters Chronic Classification Clinic Clinical Clinical Research Clinical assessments Collaborations Communication Complex Computer Simulation Condition Data Data Collection Development Device Removal Device or Instrument Development Devices Echocardiography Electronics Environment Exercise Exhibits Feedback Foundations Goals Health Heart Heart Diseases Heart Transplantation Heart failure Human Human Resources Image Imaging technology Immunosuppression Implantable Defibrillators In Vitro Individual Institution Interdisciplinary Study Invasive Knowledge Laboratories Lead Learning Left Life Longevity Magnetic Resonance Imaging Maryland Measures Mechanics Medical Device Methods Morbidity - disease rate Motion Multi-Institutional Clinical Trial Myocardial Numbers Operative Surgical Procedures Outcomes Research Oxygen Consumption Patient Care Patients Performance Peripheral Placement Principal Investigator Protocols documentation Quality of life Randomized Randomized Clinical Trials Recording of previous events Recovery Recovery of Function Regulation Rehabilitation therapy Research Research Personnel Research Project Grants Risk Selection Criteria Series Site Visit Specialist Staging Standards of Weights and Measures Suggestion Symptoms System Techniques Testing Therapeutic immunosuppression Time Time Study Training Transplantation Treatment Efficacy Treatment Protocols United States Universities Ventricular Ventricular Function Visual Weaning X-Ray Computed Tomography base design digital experience hemodynamics improved in vivo mortality multidisciplinary novel prescription document prescription procedure pressure prognostic programs prospective response success tool ventricular assist device

项目摘要

DESCRIPTION (provided by applicant): The mechanical left ventricular assist device (LVAD) is often life-saving for patients with severe heart failure. Although LVAD is typically used as a bridge to transplantation, an important subset of patients on LVAD have recovery of LV function leading to successful removal of the device. Assessment of LV function by routine clinical means is difficult or impossible on LVAD due to complex unloading effects. Accordingly, we have developed novel load-independent measures of LV function (preload adjusted maximal power) using on-line digital echocardiography and non-invasive arterial pressure. We have applied these methods to 53 selected LVAD patients, and identified LV recovery in 14 who had successful LVAD removal. This proposal uses a multi-center consortium of 3 expert LVAD centers: the University of Pittsburgh, which will lead all aspects, Penn State-Hershey, and the University of Maryland. The University of Pittsburgh team is a collaboration of cardiac imaging, heart failure and the clinical Artificial Heart Program along with bioengineering experts at Carnegie Mellon University. Aim # 1 will test the hypothesis that our novel load independent LV functional measures can reliably identify LV recovery in a series of 175-200 LVAD patients. The predictive power of routine clinical peak exercise oxygen consumption and right heart catheterization will be compared to refine selection criteria for LVAD removal. Specific Aims # 2 and #3 will test the hypothesis that LV recovery on LVAD can be facilitated: Aim #2 will use in vitro and in vivo animal experiments to refine and test a feedback controller for Synchronized LVAD operation for optimal loading to facilitate LV recovery. Aim #3 will test this strategy in a prospective multi-center randomized clinical trial where LVAD Synchronized Adaptive Reloading will be compared to routine Asynchronous LVAD operation. Lay Summary: Mechanical support with a left ventricular assist device (LVAD) can be life-saving for Patients with severe heart failure, usually as a bridge to transplantation. Although patients may have cardiac recovery while on LVAD and the device can be removed, it is difficult to assess using routine means. We will use novel non-invasive cardiac testing to identify recovery of the heart on LVAD and develop a unique control system to facilitate cardiac recovery.

描述（由申请人提供）：机械左心室辅助装置（LVAD）通常为患有严重心力衰竭的患者挽救生命。尽管LVAD通常被用作移植的桥梁，但LVAD的重要子集具有LV功能的恢复，从而成功拆除了该设备。由于复杂的卸载效应，在LVAD上难以通过常规临床手段评估LV功能。因此，我们使用在线数字超声心动图和非侵入性动脉压的LV功能（预紧力调整后的最大功率）开发了新颖的LV功能量度。我们已将这些方法应用于53位选定的LVAD患者，并确定了成功去除LVAD的14例LV恢复。该提案使用一个由3个专家LVAD中心组成的多中心财团：匹兹堡大学，该公司将领导各个方面，宾夕法尼亚州立大学和马里兰大学。匹兹堡大学团队与卡内基·梅隆大学（Carnegie Mellon University）的生物工程专家一起进行了心脏成像，心力衰竭和临床人工心脏计划的合作。 AIM＃1将检验以下假设：我们新型的独立LV功能措施可以可靠地识别一系列175-200 LVAD患者的LV恢复。将常规临床峰值运动消耗氧和右心导管插入的预测能力与精炼选择标准的LVAD去除标准进行比较。具体目标＃2和＃3将检验以下假设：LVAD上的LV回收可以促进：AIM＃2将在体外和体内动物实验中使用体内动物实验来完善和测试反馈控制器，以进行同步LVAD操作以最佳的负载以促进LV恢复。 AIM＃3将在一项前瞻性多中心随机临床试验中测试该策略，其中LVAD同步自适应重新加载将与常规异步LVAD操作进行比较。摘要摘要：使用左心室辅助装置（LVAD）的机械支撑可能会挽救生命严重心力衰竭的患者，通常是移植的桥梁。尽管患者在LVAD上可能有心脏恢复，并且可以去除设备，但很难使用常规手段进行评估。我们将使用新型的非侵入性心脏测试来确定LVAD心脏的恢复，并开发出独特的控制系统以促进心脏恢复。