ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2023
Pulsatility and flow patterns across macro- and microcirculatory arteries of continuous-flow left ventricular assist device patients.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 5 citations in OpenAlex.
- Pulsatility as a Potential Regulator of Cardiovascular Biology: Molecular, Cellular, and Hemodynamic Remodeling During Continuous-Flow Left Ventricular Assist Device Support and Following Heart Transplantation.International journal of molecular sciences · 2026Review
- Trajectories of the systemic pulsatility index after CF-LVAD implantation and clinical impact.BMC cardiovascular disorders · 2026Article
- Management of Dialysis for Patients Receiving Mechanical Circulatory Support.Journal of the American Society of Nephrology : JASN · 2026Review
- Outcomes of MagLev LVAD Support in Patients Requiring Preoperative Continuous Renal Replacement Therapy.Journal of clinical medicine · 2025Article
- Physiologic effects of different hemodynamic patterns of LVAD.Frontiers in cardiovascular medicine · 2025Review
- Assessment of Peripheral Arterial (Normal) Flows in Multiple Vascular Territories in Patients Receiving Mechanical Cardiac Support.Journal of cardiovascular echographyArticle
Corrections and comments
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Authors and funding
22 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundReduced arterial pulsatility in continuous-flow left ventricular assist devices (CF-LVAD) patients has been implicated in clinical complications. Consequently, recent improvements in clinical outcomes have been attributed to the "artificial pulse" technology inherent to the HeartMate3 (HM3) LVAD. However, the effect of the "artificial pulse" on arterial flow, transmission of pulsatility into the microcirculation and its association with LVAD pump parameters is not known.
methodsThe local flow oscillation (pulsatility index, PI) of common carotid arteries (CCAs), middle cerebral arteries (MCAs) and central retinal arteries (CRAs-representing the microcirculation) were quantified by 2D-aligned, angle-corrected Doppler ultrasound in 148 participants: healthy controls, n = 32; heart failure (HF), n = 43; HeartMate II (HMII), n = 32; HM3, n = 41.
resultsIn HM3 patients, 2D-Doppler PI in beats with "artificial pulse" and beats with "continuous-flow" was similar to that of HMII patients across the macro- and microcirculation. Additionally, peak systolic velocity did not differ between HM3 and HMII patients. Transmission of PI into the microcirculation was higher in both HM3 (during the beats with "artificial pulse") and in HMII patients compared with HF patients. LVAD pump speed was inversely associated with microvascular PI in HMII and HM3 (HMII, r
conclusionsThe "artificial pulse" of the HM3 is detectable in the macro- and microcirculation but without creating a significant alteration in PI compared with HMII patients. Increased transmission of pulsatility and the association between pump speed and PI in the microcirculation indicate that the future clinical care of HM3 patients may involve individualized pump settings according to the microcirculatory PI in specific end-organs.
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