ArticleJHLT open2025
Patient-specific hemodynamic modeling to optimize LVAD speed and right heart health.
Article in JHLT open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Optimizing left ventricular assist device speed: a systematic review for the heart failure clinician.Future cardiology · 2025Pooled it
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Left ventricular assist device (LVAD) speed optimization and right heart failure post device implantation are major clinical challenges. Right heart catheterization (RHC)-guided speed titration studies are often performed to optimize LVAD settings, which are unknown and must be optimized for each patient. A virtual hemodynamic model (VHM) that can be tailored to each patient may provide useful guidance and reduce repeated studies. Methods: We conducted a retrospective analysis on 16 patients implanted with HeartMate 3 (HM3) who underwent RHC speed titration study as an outpatient. A custom-designed VHM was built and customized for each patient based on RHC measurements. VHM predictions were obtained for multiple scenarios: (1) population-based pulmonary system parameters, (2) patient-specific systemic and pulmonary resistance and capacitance parameters, (3) clinical optimization-based patient-specific mean arterial pressure (MAP), and (4) several MAP targets ranging from 70 to 90 mm Hg. Results: All patients who underwent RHC speed titration had a clinician-guided speed increase, with a median increase of 300 revolutions per minute (rpm). Using each patient's customized VHM, virtual speed optimization demonstrated congruence with clinician-guided optimization, with a median predicted speed increase of 321 rpm. After virtual optimization, there was a decrease in the pulmonary artery pressure for 13 patients (81.25%), indicating a predicted improvement in pulmonary parameters. Conclusions: For our cohort of 16 patients, there was an overall congruence between clinician-guided and patient-specific VHM-predicted optimal LVAD speeds. The magnitude of speed change varied depending on individual patient targets. This may provide individualized speed titration goals and lessen the need for repeat invasive studies.
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