Mechanically reducing regional left ventricular wall stress and improving ejection fraction in heart failure patients

T. Urgert (Corresponding Author), F.R. Halfwerk, Rob Hagmeijer, M. van den Heuvel, J.G. Grandjean

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Objectives: Heart failure with reduced Ejection Fraction (HFrEF) is a pro-gressive disease with a low 5-year survival of <50%, which affects 23 million people worldwide. It is characterized by adverse remodeling of the left ventricle (dilated cardiomyopathy) due to an increase in filling pressures and myocardial wall stress. Pharmacological treatment and cardiac resynchronisation therapy have proven beneficial for survival. For patients with end-stage heart failure, a heart transplant or Left Ventricular Assist Device can be considered. A shortage of donors, patient selection and major downsides such as invasiveness and drive-line infections limit the use of these treatments. Research has shown a 13% decrease in mortality for every 5% increase in left ventricular ejec-tion fraction. Therefore, we developed a smart memory alloy configura-tion in order to increase the ejection fraction and obtain an increase of 3,5% in a bench model. To cope with ongoing left ventricular dilatation and rise in wall stress, this should be combined with adjustable and measurable ventricular restraint therapy. Our first aim is to measure local wall stress during a full cardiac cycle. Next, we aim to develop a mathematical model of the left ventricle to characterize the left ventricle in HFrEF patients. Methods: We will characterize in vivo wall stresses during the full car-diac cycle using Transesophageal Echocardiography and a left ventricular pressure catheter in 10 patients undergoing cardiac surgery for heart failure. With these parameters, we will develop a simplified mathemati-cal model of the left ventricle and we will improve our bench model for experimental testing. Results: This research will provide a characterization of the weakened left ventricular wall and the determination of optimal smart material properties and configuration of the cardiac assist device. Discussion: With this information, a patient-specific HFrEF treatment device will be developed combining active cardiac support and restraint therapy
Original languageEnglish
Article numberP112
Pages (from-to)419-420
Number of pages2
JournalInternational journal of artificial organs
Volume42
Issue number8
Publication statusE-pub ahead of print/First online - 12 Aug 2019
EventXLVI ESAO Congress 2019: Smartificial devices for our future - Conti Campus, Hannover, Germany
Duration: 3 Sep 20197 Sep 2019
Conference number: 46
https://www.esao2019.org/

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Heart Failure
Heart Ventricles
Theoretical Models
Cardiac resynchronization therapy
Therapeutics
Donor Selection
Equipment and Supplies
Cardiac Resynchronization Therapy
Ventricular Remodeling
Heart-Assist Devices
Left ventricular assist devices
Survival
Transesophageal Echocardiography
Dilated Cardiomyopathy
Echocardiography
Ventricular Pressure
Transplants
Intelligent materials
Research
Catheters

Cite this

@article{fdecc625a44b4980b3a9aafcf9c9e709,
title = "Mechanically reducing regional left ventricular wall stress and improving ejection fraction in heart failure patients",
abstract = "Objectives: Heart failure with reduced Ejection Fraction (HFrEF) is a pro-gressive disease with a low 5-year survival of <50{\%}, which affects 23 million people worldwide. It is characterized by adverse remodeling of the left ventricle (dilated cardiomyopathy) due to an increase in filling pressures and myocardial wall stress. Pharmacological treatment and cardiac resynchronisation therapy have proven beneficial for survival. For patients with end-stage heart failure, a heart transplant or Left Ventricular Assist Device can be considered. A shortage of donors, patient selection and major downsides such as invasiveness and drive-line infections limit the use of these treatments. Research has shown a 13{\%} decrease in mortality for every 5{\%} increase in left ventricular ejec-tion fraction. Therefore, we developed a smart memory alloy configura-tion in order to increase the ejection fraction and obtain an increase of 3,5{\%} in a bench model. To cope with ongoing left ventricular dilatation and rise in wall stress, this should be combined with adjustable and measurable ventricular restraint therapy. Our first aim is to measure local wall stress during a full cardiac cycle. Next, we aim to develop a mathematical model of the left ventricle to characterize the left ventricle in HFrEF patients. Methods: We will characterize in vivo wall stresses during the full car-diac cycle using Transesophageal Echocardiography and a left ventricular pressure catheter in 10 patients undergoing cardiac surgery for heart failure. With these parameters, we will develop a simplified mathemati-cal model of the left ventricle and we will improve our bench model for experimental testing. Results: This research will provide a characterization of the weakened left ventricular wall and the determination of optimal smart material properties and configuration of the cardiac assist device. Discussion: With this information, a patient-specific HFrEF treatment device will be developed combining active cardiac support and restraint therapy",
author = "T. Urgert and F.R. Halfwerk and Rob Hagmeijer and {van den Heuvel}, M. and J.G. Grandjean",
year = "2019",
month = "8",
day = "12",
language = "English",
volume = "42",
pages = "419--420",
journal = "International journal of artificial organs",
issn = "0391-3988",
publisher = "Wichtig Publishing",
number = "8",

}

Mechanically reducing regional left ventricular wall stress and improving ejection fraction in heart failure patients. / Urgert, T. (Corresponding Author); Halfwerk, F.R.; Hagmeijer, Rob ; van den Heuvel, M.; Grandjean, J.G.

In: International journal of artificial organs, Vol. 42, No. 8, P112, 12.08.2019, p. 419-420.

Research output: Contribution to journalMeeting AbstractAcademic

TY - JOUR

T1 - Mechanically reducing regional left ventricular wall stress and improving ejection fraction in heart failure patients

AU - Urgert, T.

AU - Halfwerk, F.R.

AU - Hagmeijer, Rob

AU - van den Heuvel, M.

AU - Grandjean, J.G.

PY - 2019/8/12

Y1 - 2019/8/12

N2 - Objectives: Heart failure with reduced Ejection Fraction (HFrEF) is a pro-gressive disease with a low 5-year survival of <50%, which affects 23 million people worldwide. It is characterized by adverse remodeling of the left ventricle (dilated cardiomyopathy) due to an increase in filling pressures and myocardial wall stress. Pharmacological treatment and cardiac resynchronisation therapy have proven beneficial for survival. For patients with end-stage heart failure, a heart transplant or Left Ventricular Assist Device can be considered. A shortage of donors, patient selection and major downsides such as invasiveness and drive-line infections limit the use of these treatments. Research has shown a 13% decrease in mortality for every 5% increase in left ventricular ejec-tion fraction. Therefore, we developed a smart memory alloy configura-tion in order to increase the ejection fraction and obtain an increase of 3,5% in a bench model. To cope with ongoing left ventricular dilatation and rise in wall stress, this should be combined with adjustable and measurable ventricular restraint therapy. Our first aim is to measure local wall stress during a full cardiac cycle. Next, we aim to develop a mathematical model of the left ventricle to characterize the left ventricle in HFrEF patients. Methods: We will characterize in vivo wall stresses during the full car-diac cycle using Transesophageal Echocardiography and a left ventricular pressure catheter in 10 patients undergoing cardiac surgery for heart failure. With these parameters, we will develop a simplified mathemati-cal model of the left ventricle and we will improve our bench model for experimental testing. Results: This research will provide a characterization of the weakened left ventricular wall and the determination of optimal smart material properties and configuration of the cardiac assist device. Discussion: With this information, a patient-specific HFrEF treatment device will be developed combining active cardiac support and restraint therapy

AB - Objectives: Heart failure with reduced Ejection Fraction (HFrEF) is a pro-gressive disease with a low 5-year survival of <50%, which affects 23 million people worldwide. It is characterized by adverse remodeling of the left ventricle (dilated cardiomyopathy) due to an increase in filling pressures and myocardial wall stress. Pharmacological treatment and cardiac resynchronisation therapy have proven beneficial for survival. For patients with end-stage heart failure, a heart transplant or Left Ventricular Assist Device can be considered. A shortage of donors, patient selection and major downsides such as invasiveness and drive-line infections limit the use of these treatments. Research has shown a 13% decrease in mortality for every 5% increase in left ventricular ejec-tion fraction. Therefore, we developed a smart memory alloy configura-tion in order to increase the ejection fraction and obtain an increase of 3,5% in a bench model. To cope with ongoing left ventricular dilatation and rise in wall stress, this should be combined with adjustable and measurable ventricular restraint therapy. Our first aim is to measure local wall stress during a full cardiac cycle. Next, we aim to develop a mathematical model of the left ventricle to characterize the left ventricle in HFrEF patients. Methods: We will characterize in vivo wall stresses during the full car-diac cycle using Transesophageal Echocardiography and a left ventricular pressure catheter in 10 patients undergoing cardiac surgery for heart failure. With these parameters, we will develop a simplified mathemati-cal model of the left ventricle and we will improve our bench model for experimental testing. Results: This research will provide a characterization of the weakened left ventricular wall and the determination of optimal smart material properties and configuration of the cardiac assist device. Discussion: With this information, a patient-specific HFrEF treatment device will be developed combining active cardiac support and restraint therapy

M3 - Meeting Abstract

VL - 42

SP - 419

EP - 420

JO - International journal of artificial organs

JF - International journal of artificial organs

SN - 0391-3988

IS - 8

M1 - P112

ER -