Effects of the left ventricular assist device on the compliance and distensibility of the carotid artery

Danielle L. Templeton, Ranjit John, Patricia Painter, Aaron S. Kelly, Donald R. Dengel

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

We investigated the impact of continuous-flow left ventricular assist devices (LVAD) on the carotid elastic properties. Carotid artery parameters (diameter distensibility (DD), cross-sectional distensibility (CSD), diameter compliance (DC), cross-sectional compliance (CSC), and incremental elastic modulus (IEM)) were measured in a cross-sectional study using a standard ultrasound with a 10-MHz linear array probe. Measurements (mean ± SEM) were made in separate groups at various clinical time points: prior to LVAD surgery (baseline; 13 male/3 female; age 48 ± 3 years), 1 week following LVAD placement (acute; 12 male/2 female; age 47 ± 3 years), approximately 24 weeks following LVAD surgery (chronic; 13 male/2 female; age 52 ± 3 years), and in a group of healthy subjects (controls; 9 male/1 female; age 51 ± 4 years). Distensibility properties were lower (P < 0.05) in the acute (DD 2.3 % ± 0.4 %; CSD 4.7 % ± 0.8 %) and chronic (DD 2.2 % ± 0.4 %; CSD 4.5 ± 0.9 %) compared with the baseline (DD 5.9 % ± 0.7 %; CSD 12.2 % ± 1.5 %) and control (DD 5.8 % ± 0.6 %; CSD 11.9 % ± 1.3 %) groups. Compliance properties were lower (P < 0.05) in the chronic (DC 4.4 ± 0.7 mm/mmHg × 10-3; CSC 1.2 ± 0.2 mmHg-1 × 10-3) compared with acute (DC 9.0 ± 1.6 mm/mmHg × 10-3; CSC 2.6 ± 0.4 mmHg-1 × 10-3) and baseline (DC 11.1 ± 1.1 mm/mmHg × 10-3; CSC 3.3 ± 0.4 mmHg-1 × 10-3) groups. The compliance properties in the control (DC 8.3 ± 0.8 mm/mmHg × 10-3; CSC 2.4 ± 0.2 mmHg -1 × 10-3) group were not different from any of the patient groups. The IEM was higher (P < 0.05) in the chronic (6908 ± 1269 mmHg) compared with acute (2739 ± 412 mmHg), baseline (1849 ± 177 mmHg), and control (2349 ± 241 mmHg) groups. Chronic continuous-flow LVAD support is associated with lower carotid artery compliance and distensibility, which may place further strain on the left ventricle.

Original languageEnglish (US)
Pages (from-to)377-384
Number of pages8
JournalHeart and Vessels
Volume28
Issue number3
DOIs
StatePublished - May 1 2013

Keywords

  • Carotid artery
  • Compliance
  • Continuous-flow left ventricular assist device
  • Distensibility
  • Heart failure

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