ArticleJournal of translational medicine2020
Increasing venoarterial extracorporeal membrane oxygenation flow puts higher demands on left ventricular work in a porcine model of chronic heart failure.
Article in Journal of translational medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 15 citations in OpenAlex.
- Impella Versus Selective Biatrial Canulation for Left Ventricular Unloading During Extracorporeal Membrane Oxygenation.Cardiovascular therapeutics · 2026Trial
- New Insights into Cardiac Intensive Care.Reviews in cardiovascular medicine · 2026Review
- Transaortic Catheter Venting for Left Ventricular Unloading in Veno-Arterial Extracorporeal Life Support: A Porcine Cardiogenic Shock Model.Medicina (Kaunas, Lithuania) · 2025Article
- The physiology of venoarterial extracorporeal membrane oxygenation - A comprehensive clinical perspective.Perfusion · 2024Review
- Afterload pressure and left ventricular contractility synergistically affect left atrial pressure during veno-arterial ECMO.JHLT open · 2024Article
- A large arteriovenous fistula steals a considerable part of systemic blood flow during veno-arterial extracorporeal circulation support in a porcine model.Frontiers in physiology · 2023Article
- Effects of varying blood flow rate during peripheral veno-arterial extracorporeal membrane oxygen (V-A ECMO) on left ventricular function measured by two-dimensional strain.Frontiers in cardiovascular medicine · 2023Article
- Ten years of our translational research in the field of veno-arterial extracorporeal membrane oxygenation.Physiological research · 2022Review
- Left Atrial Decompression in Pediatric Patients Supported With Extracorporeal Membrane Oxygenation for Failure to Wean From Cardiopulmonary Bypass: A Propensity-Weighted Analysis.Journal of the American Heart Association · 2022Article
- Aortic stenosis and mitral regurgitation modify the effect of venoarterial extracorporeal membrane oxygenation on left ventricular function in cardiogenic shock.Scientific reports · 2022Article
- New Porcine Model of Arteriovenous Fistula Documents Increased Coronary Blood Flow at the Cost of Brain Perfusion.Frontiers in physiology · 2022Article
- Hemodynamic adaptation of heart failure to percutaneous venoarterial extracorporeal circulatory supports.Physiological research · 2020Review
- Increasing Veno-Arterial Extracorporeal Membrane Oxygenation Flow Reduces Electrical Impedance of the Lung Regions in Porcine Acute Heart Failure.Physiological research · 2020Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVenoarterial extracorporeal membrane oxygenation (VA ECMO) is widely used in the treatment of circulatory failure, but repeatedly, its negative effects on the left ventricle (LV) have been observed. The purpose of this study is to assess the influence of increasing extracorporeal blood flow (EBF) on LV performance during VA ECMO therapy of decompensated chronic heart failure.
methodsA porcine model of low-output chronic heart failure was developed by long-term fast cardiac pacing. Subsequently, under total anesthesia and artificial ventilation, VA ECMO was introduced to a total of five swine with profound signs of chronic cardiac decompensation. LV performance and organ specific parameters were recorded at different levels of EBF using a pulmonary artery catheter, a pressure-volume loop catheter positioned in the LV, and arterial flow probes on systemic arteries.
resultsTachycardia-induced cardiomyopathy led to decompensated chronic heart failure with mean cardiac output of 2.9 ± 0.4 L/min, severe LV dilation, and systemic hypoperfusion. By increasing the EBF from minimal flow to 5 L/min, we observed a gradual increase of LV peak pressure from 49 ± 15 to 73 ± 11 mmHg (P = 0.001) and an improvement in organ perfusion. On the other hand, cardiac performance parameters revealed higher demands put on LV function: LV end-diastolic pressure increased from 7 ± 2 to 15 ± 3 mmHg, end-diastolic volume increased from 189 ± 26 to 218 ± 30 mL, end-systolic volume increased from 139 ± 17 to 167 ± 15 mL (all P < 0.001), and stroke work increased from 1434 ± 941 to 1892 ± 1036 mmHg*mL (P < 0.05). LV ejection fraction and isovolumetric contractility index did not change significantly.
conclusionsIn decompensated chronic heart failure, excessive VA ECMO flow increases demands and has negative effects on the workload of LV. To protect the myocardium from harm, VA ECMO flow should be adjusted with respect to not only systemic perfusion, but also to LV parameters.
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