As outlined above, the HIT-LVAD project has already generated a variety of different outputs, some which are final and many more that are preliminary, as indicated by abstracts, posters and presentations. Furthermore, the opportunity to compare the biology of the 3GLVAD with other LVADs as well as with the physiology of healthy controls presents a unique opportunity that is expected to generate high-impact publications in leading medical journals. One reason why the HIT-LVAD project can be reasonably expected to produce such high-profile publications with wide-reaching impact is the current lack of knowledge and the reliance on assumptions amongst medics. For example, because of an in-built ‘artificial pulse’,1 the 3rd generation LVAD is expected by practitioners to ‘add pulsatility’ to the circulation of these patients. However, the HIT-LVAD project has collected unique data that contradict this currently wide-held belief. Specifically, a prospective study by the HIT-LVAD project reveals that the average pulsatility of the 3GLVAD is no different from that of the 2GLVAD. This finding is of huge importance, as it will impact on the interpretation of the biology of these patients, which may influence the diagnostic approach and the therapeutic management of these patients. As such, the HIT-LVAD project is expected to have a large impact on a wide range of clinical personnel (nurses for education and knowledge of the biology of the patients; clinicians for education and knowledge of the biology of the patients as well as diagnostic and therapeutic decision making; and clinical researchers). In addition, the findings from the HIT-LVAD project are expected to impact on the patients, by either providing the basis to modify existing LVAD parameters/settings based upon the updated knowledge, but also by impacting on the patient’s wellbeing through an enhanced confidence in the knowledge of the underlying biology that is associated with 3GLVADs. Consequently, patients may feel less anxious and will be able to have more precise conversations with their cardiologists and nurses about the progression of their condition. Similarly, the findings are expected to impact engineers who work on developing and improving new medical devices such as LVADs, by providing the scientific knowledge that can be transferred to medicine, research and industry. Because of the findings of the HIT-LVAD project, future LVAD developers are likely to consult the HIT-LVAD team for advice on the optimisation of mechanical heart pumps, as has already happened with a group from France. In this regard, the HIT-LVAD project is also expected to have significant economic impact as the findings lend themselves to the improvement of existing devices (LVADs, BP monitors etc.) as well as the generation of potentially new devices. Should the efforts of amended BP monitors be successful, the HIT-LVAD project would be the first and only in the world to provide an evidence-based BP monitor for these patients. At present, the action concludes that any improvements in risk require more detailed clinical monitoring of LVAD patients that take into account the new blood pressure, micro- and macrocirculatory patterns highlighted by the action.
