{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:35:34Z","timestamp":1792726534403,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is considerable debate about the hemodynamic effects of veno\u2010arterial extracorporeal membrane oxygenation (VA\u2010ECMO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the changes in left ventricular (LV) function, volumes, and work in patients treated with VA\u2010ECMO using invasive LV catheterization and three\u2010dimensional echocardiographic volumes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients on VA\u2010ECMO underwent invasive hemodynamic evaluation due to concerns regarding candidacy for decannulation. Hemodynamic parameters were reported as means\u00b1standard deviations or medians (interquartile ranges) after evaluating for normality. Paired comparisons were done to evaluate hemodynamics at the baseline (highest) and lowest tolerated levels of VA\u2010ECMO support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty patients aged 52.3\u2009\u00b1\u200915.8 years were included. All patients received VA\u2010ECMO for refractory cardiogenic shock (5\/20 SCAI stage D, 15\/20 SCAI stage E). At 3.0 (2.0, 4.0) days after VA\u2010ECMO cannulation, the baseline LV ejection fraction was 20% (15%, 27%). The baseline and lowest VA\u2010ECMO flows were 4.0\u2009\u00b1\u20090.6 and 1.5\u2009\u00b1\u20090.6\u2009L\/min, respectively. Compared to the lowest flow, full VA\u2010ECMO support reduced LV end\u2010diastolic volume [109\u2009\u00b1\u200981 versus 134\u2009\u00b1\u200993\u2009mL, <jats:italic>p<\/jats:italic>\u2009=\u20090.001], LV end\u2010diastolic pressure (14\u2009\u00b1\u20099 vs. 19\u2009\u00b1\u20099\u2009mmHg, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), LV stroke work (1858\u2009\u00b1\u20091413 vs. 2550\u2009\u00b1\u20091486\u2009mL*mmHg, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), and LV pressure\u2010volume area (PVA) (4507\u2009\u00b1\u20091910 vs. 5193\u2009\u00b1\u20092388, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) respectively. Mean arterial pressure was stable at the highest and lowest flows (80\u2009\u00b1\u200916 vs. 75\u2009\u00b1\u200914, respectively; <jats:italic>p<\/jats:italic>\u2009=\u20090.08) but arterial elastance was higher at the highest VA\u2010ECMO flow (4.9\u2009\u00b1\u20092.2 vs lowest flow 2.7\u2009\u00b1\u20091.6; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High flow VA\u2010ECMO support significantly reduced LV end\u2010diastolic pressure, end\u2010diastolic volume, stroke work, and PVA compared to minimal support. The Ea was higher and MAP was stable or minimally elevated on high flow.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30951","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T09:29:09Z","timestamp":1704878949000},"page":"472-481","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Left ventricular hemodynamics with veno\u2010arterial extracorporeal membrane oxygenation"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8982-0595","authenticated-orcid":false,"given":"Rajat","family":"Kalra","sequence":"first","affiliation":[{"name":"Cardiovascular Division University of Minnesota Minneapolis Minnesota USA"},{"name":"Center for Resuscitation Medicine University of Minnesota Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8381-6299","authenticated-orcid":false,"given":"Tamas","family":"Alexy","sequence":"additional","affiliation":[{"name":"Cardiovascular Division University of Minnesota Minneapolis Minnesota USA"},{"name":"Center for Resuscitation Medicine University of Minnesota Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Bartos","sequence":"additional","affiliation":[{"name":"Cardiovascular Division University of Minnesota Minneapolis Minnesota USA"},{"name":"Center for Resuscitation Medicine University of Minnesota Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2209-1831","authenticated-orcid":false,"given":"Anthony R.","family":"Prisco","sequence":"additional","affiliation":[{"name":"Cardiovascular Division University of Minnesota Minneapolis Minnesota 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