{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:16:45Z","timestamp":1787984205547,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venoarterial extracorporeal membrane oxygenation (VA\u2010ECMO) increases systemic afterload, potentially elevating mean left atrial pressure (mLAP). How baseline ventricular\u2010arterial coupling modifies this effect remains unclear. Our aim was to determine how baseline cardiac power output (CPO) and systemic vascular resistance (SVR) modify the mLAP response to VA\u2010ECMO, with or without valvular regurgitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a biventricular mock circulatory loop with peripheral VA\u2010ECMO cannulation, we simulated 12 cardiogenic shock states. Measurements were obtained at baseline and at VA\u2010 ECMO pump speeds of 2000\u20134000 RPM. Results were stratified by baseline SVR (&lt;\u200920 vs. \u2265\u200920 Wood units), CPO (&lt;\u20090.20 vs. \u2265\u20090.20\u2009W) and valve competence. Severe aortic and mitral regurgitation were tested independently as additional conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      With competent valves, mLAP decreased from 27.0\u2009\u00b1\u20090.2\u2009mmHg at baseline to 19.0\u2009\u00b1\u20090.6\u2009mmHg at 3000 RPM, then increased to 22.0\u2009\u00b1\u20090.9\u2009mmHg at 4000 RPM. High baseline SVR produced greater mLAP reduction at 3000 RPM (15.0\u2009\u00b1\u20090.6 vs. 20.0\u2009\u00b1\u20090.7\u2009mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) but steeper rebound at 4000 RPM (26.0\u2009\u00b1\u20091.1 vs. 20.0\u2009\u00b1\u20090.9\u2009mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to low SVR. Higher baseline CPO (\u2265\u20090.20\u2009W) maintained lower mLAP at higher speeds (16.0\u2009\u00b1\u20090.6 vs. 21.0\u2009\u00b1\u20090.7\u2009mmHg at 3500 RPM;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Aortic regurgitation (AR) elevated mLAP above baseline (36.0\u2009\u00b1\u20091.5 vs. 22.0\u2009\u00b1\u20090.9\u2009mmHg at 4000 RPM;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), amplified by high SVR (47.0\u2009\u00b1\u20091.1 vs. 29.0\u2009\u00b1\u20090.8\u2009mmHg at 4000 RPM). Mitral regurgitation elevated mLAP above baseline at higher pump speeds (32.0\u2009\u00b1\u20091.4 vs. 22.0\u2009\u00b1\u20090.9\u2009mmHg at 4000 RPM;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline ventricular\u2013arterial coupling modifies mLAP response to VA\u2010ECMO. Low CPO with high SVR, particularly with AR, narrows the safe pump speed window and may require early left ventricular unloading, inotropic support, or vascular resistance optimization. These findings support phenotype\u2010guided VA\u2010ECMO titration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70168","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:14:41Z","timestamp":1778822081000},"page":"1228-1236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline Ventricular\u2010Arterial Coupling Modifies Left Atrial Pressure Response to Venoarterial Extracorporeal Membrane Oxygenation In\u00a0Vitro"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6121-8949","authenticated-orcid":false,"given":"Christian","family":"Said","sequence":"first","affiliation":[{"name":"The University of New South Wales  Kensington New South Wales Australia"},{"name":"The Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"St Vincent's Hospital  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hayward","sequence":"additional","affiliation":[{"name":"The University of New South Wales  Kensington New South Wales Australia"},{"name":"The Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"St Vincent's Hospital  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Deveza","sequence":"additional","affiliation":[{"name":"The University of New South Wales  Kensington New South Wales Australia"},{"name":"The Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"St Vincent's Hospital  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumita","family":"Barua","sequence":"additional","affiliation":[{"name":"The University of New South Wales  Kensington New South Wales Australia"},{"name":"The Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"St Vincent's Hospital  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavitha","family":"Muthiah","sequence":"additional","affiliation":[{"name":"The University of New South Wales  Kensington New South Wales Australia"},{"name":"The Victor Chang Cardiac Research Institute  Darlinghurst New South Wales Australia"},{"name":"St Vincent's Hospital  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Jain","sequence":"additional","affiliation":[{"name":"The University of New South Wales  Kensington New South Wales Australia"},{"name":"Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"The University of Sydney  Camperdown New South Wales 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