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

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    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/

    Fingerprint

    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 -