Periodic Reporting for period 2 - HIT-LVAD (Understanding blood pressure and vascular haemodynamics in implanted Left Ventricular Assist Device patients.)
Reporting period: 2018-09-01 to 2019-08-31
Historically, the second-generation LVAD patients (2G-LVAD pts) have significantly improved the survival of patients with advance HF, despite producing continuous flow and ""humans with no pulse"". Unfortunately, patients can still develop serious complications such as gastrointestinal bleeding, right heart failure, and stroke, categorised as “haemodynamic issues”. For this reason, the HIT-LVAD project was initiated, with the overall aim to improve the current understanding of the physiology that underpins the drastically altered circulation in 2G-LVAD pts, thus assisting in explaining risk in those on non-pulsatile LVADs."
Specifically, the action has created the largest database of haemodynamics in LVAD, showing that heart failure patients have an increased pulsatility, while 2G-LVAD pts have a substantially increased flow in the microcirculation. Together with the successful completion of a study revealing the impact of blood pressure on risk in 2G-LVAD pts, and the simultaneous validation of a blood pressure monitor, clinicians can now assess blood pressure in these patients and manage the disease in a better manner, thus reducing complications and improving the patients’ lives. Similarly, the HIT-LVAD peoject showed that aortic stiffness is related to clinical outcomes in 2G-LVAD pts, and that carotid artery plaques present prior to LVAD surgery are likely ot play a previously underestimated role in complications in LVAD pts. in addition to the original aims of the action, the research has been extended to 3G-LVAD, refuting the current belief that 3G-LVAD pts have an increased pulsatility. This highly highly novel, timely and clinically-relevant advancement to the current thinking creates the opportunity for a large body of research into the specific mechanisms of improved outcomes in 3G-LVAD pts. Finally, the action has been able to show that 3G-LVAD pts have an improved reactivity in their brains, and current efforts into validating a blood pressure monitor in this cohort will further advance the knowledge and socio-economic impact of the HIT-LVAD project.