{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T21:47:57Z","timestamp":1762033677518,"version":"3.40.5"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T00:00:00Z","timestamp":1571702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patients supported with a left ventricular assist device (LVAD) have impaired cardiovascular adaptations during exercise, resulting in reduced total cardiac output and exercise intolerance. The aim of this study is to report associations among these impaired cardiovascular parameters and exercise hemodynamics, and to identify in which conditions an LVAD speed increase can provide substantial benefits to exercise. A cardiorespiratory simulator was used to reproduce the average hemodynamics of LVAD patients at exercise. Then, a sensitivity study was conducted where cardiovascular parameters were changed individually \u00b120% of their baseline value at exercise (heart rate, left\/right ventricular contractility, total peripheral resistance, and valve pathologies). Simulations were performed at a baseline LVAD speed of 2700 rpm and repeated at 3500 rpm to evaluate the benefits of a higher LVAD support on hemodynamics. Total cardiac output (TCO) was mostly impaired by a poor left ventricular contractility or vasodilation at exercise (\u22120.6 L\/min), followed by a poor chronotropic response (\u22120.3 L\/min) and by a poor right ventricular contractility (\u22120.2 L\/min). LVAD speed increase better unloads the left ventricle and improves total cardiac output in all the simulated conditions. The most substantial benefits from LVAD speed increase were observed in case of poor left ventricular contractility (TCO + 1.6 L\/min) and vascular dysfunction (TCO + 1.4 L\/min) followed by lower heart rate (TCO + 1.3 L\/min) and impaired right ventricular contractility (TCO + 1.1 L\/min). Despite the presence of the LVAD, exercise hemodynamic is strongly depending on the ability of the cardiovascular system to adapt to exercise. A poor left ventricular inotropic response and a poor vascular function can strongly impair cardiac output at exercise. In these conditions, LVAD speed increase can be an effective strategy to augment total cardiac output and unload the left ventricle. These results evidence the need to design a physiological LVAD speed controller, tailored on specific patient\u2019s needs.<\/jats:p>","DOI":"10.1111\/aor.13569","type":"journal-article","created":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T22:13:47Z","timestamp":1568412827000},"page":"239-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["LVAD speed increase during exercise, which patients would benefit the most? A simulation study"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1583-5783","authenticated-orcid":false,"given":"Christoph","family":"Gross","sequence":"first","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"},{"name":"Ludwig\u2010Boltzmann\u2010Cluster for Cardiovascular Research Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0279-6615","authenticated-orcid":false,"given":"Francesco","family":"Moscato","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"},{"name":"Ludwig\u2010Boltzmann\u2010Cluster for Cardiovascular Research Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4354-4860","authenticated-orcid":false,"given":"Thomas","family":"Schl\u00f6glhofer","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"},{"name":"Ludwig\u2010Boltzmann\u2010Cluster for Cardiovascular Research Vienna Austria"},{"name":"Department of Cardiac Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Maw","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"},{"name":"Ludwig\u2010Boltzmann\u2010Cluster for Cardiovascular Research Vienna Austria"},{"name":"Department of Cardiac Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"Meyns","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Katholieke Universiteit Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane","family":"Marko","sequence":"additional","affiliation":[{"name":"PVA Center for Ambulatory Rehabilitation Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Wiedemann","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Zimpfer","sequence":"additional","affiliation":[{"name":"Ludwig\u2010Boltzmann\u2010Cluster for Cardiovascular Research Vienna Austria"},{"name":"Department of Cardiac Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinrich","family":"Schima","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria"},{"name":"Ludwig\u2010Boltzmann\u2010Cluster for Cardiovascular Research Vienna Austria"},{"name":"Department of Cardiac Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-8340","authenticated-orcid":false,"given":"Libera","family":"Fresiello","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Katholieke Universiteit Leuven Leuven Belgium"},{"name":"Institute of Clinical Physiology National Research Council Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.10.003"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.12.006"},{"key":"e_1_2_11_4_1","article-title":"LVAD pump flow does not adequately increase with exercise","author":"Gross C","year":"2018","journal-title":"Artif Organs"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12151"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.193698"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs042"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.110.958041"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezw147"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2011.01227.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.52"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchv.2014.07.004"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12070"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.12.112"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2016.00189"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0181879"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398819846126"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.10.001"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.11.004"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.11.001"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.05.009"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy126"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2010.01168.x"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000285"},{"key":"e_1_2_11_25_1","article-title":"Impact of pump speed on hemodynamics with exercise in continuous flow ventricular assist device patients","volume":"1","author":"Lai JV","year":"2019","journal-title":"ASAIO J."},{"key":"e_1_2_11_26_1","article-title":"Computed tomography\u2010estimated right ventricular function and exercise capacity in patients with continuous\u2010flow left ventricular assist devices","volume":"1","author":"Mirza KK","year":"2018","journal-title":"ASAIO J."},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2005.11.439"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-011-9321-z"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.04.012"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.01.999"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.06.020"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487319856448"},{"key":"e_1_2_11_33_1","unstructured":"HeartWare Inc.HeartWareTMHVADTMSystem Instructions for Use(IFU00375 Rev06 06\/18) [Internet].2018. Available from:https:\/\/www.heartware.com\/sites\/default\/files\/uploads\/docs\/ifu00375_rev06_hvad_ifu_en-electronic.pdf"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faor.13569","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.13569","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aor.13569","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.13569","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T09:59:26Z","timestamp":1693821566000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.13569"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,22]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1111\/aor.13569"],"URL":"https:\/\/doi.org\/10.1111\/aor.13569","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"type":"print","value":"0160-564X"},{"type":"electronic","value":"1525-1594"}],"subject":[],"published":{"date-parts":[[2019,10,22]]},"assertion":[{"value":"2019-07-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}