Acute cardiac care & resuscitation
Pressure–Strain Loops Unveil Haemodynamics Behind Mechanical Circulatory Support Systems
Authors' conclusion
PS loops analysis in patients undergoing MCS seems to be feasible and may unveil MCS-induced haemodynamic variations.
Study context
- Population
- Consecutive patients undergoing mechanical circulatory support (MCS) positioning/implantation in a third level cardiological ICU, Siena Hospital, August 2021–November 20219 excluded
- Participants
- 18 patients
- Exposure
- Haemodynamic profiling by pressure-strain (PS) loops across MCS systems
- Intra-aortic balloon pump (IABP)n = 3
- Durable left ventricular assist device (dLVAD)n = 2
- Impella®n = 2
- Extracorporeal membrane oxygenation (ECMO)n = 1
- ECMO and IABPn = 1
- Outcome
- Non-invasive haemodynamic profiling by pressure-strain (myocardial work) analysis
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Myocardial work / PS loops
- Myocardial work analysis feasible in each included patient
- IABP: PS curve shifted rightward and downward; Global work index (GWI) and global wasted work (GWW) decreased, global work efficiency (GWE) increased
- Continuous-flow pumps (Impella®, dLVAD): PS loop shifted towards a triangular shape
- ECMO alone: narrower PS loop, decreased GWI and GWE, increased GWW and mean arterial pressure
- ECMO with IABP: wider PS loop, improved GWI and GWE
Observational data: associations, not effects.
Original publication
Pressure–Strain Loops Unveil Haemodynamics Behind Mechanical Circulatory Support Systems. ESC Heart Fail. Published 21 June 2023. doi:10.
Summarised from the published abstract; every number is checked against it