{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:40:50Z","timestamp":1792194050383,"version":"4.4.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Continuous-flow (CF) left ventricular assist devices (LVADs) improve outcomes for patients with advanced heart failure (HF). However, the lack of a physiological pulse predisposes to side-effects including uncontrolled blood pressure (BP), and there are little data regarding the impact of CF-LVADs on BP regulation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              Twelve patients (10 males, 60\u00b111 years) with advanced heart failure completed hemodynamic assessment 2.7\u00b14.1 months before, and 4.3\u00b11.3 months following CF-LVAD implantation. Heart rate and systolic BP via arterial catheterization were monitored during Valsalva maneuver, spontaneous breathing, and a 0.05 Hz repetitive squat-stand maneuver to characterize cardiac baroreceptor sensitivity. Plasma norepinephrine levels were assessed during head-up tilt at supine, 30\n              <jats:sup>o<\/jats:sup>\n              and 60\n              <jats:sup>o<\/jats:sup>\n              . Heart rate and BP were monitored during cardiopulmonary exercise testing.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Cardiac baroreceptor sensitivity, determined by Valsalva as well as Fourier transformation and transfer function gain of Heart rate and systolic BP during spontaneous breathing and squat-stand maneuver, was impaired before and following LVAD implantation. Norepinephrine levels were markedly elevated pre-LVAD and improved\u2014but remained elevated post-LVAD (supine norepinephrine pre-LVAD versus post-LVAD: 654\u00b1437 versus 323\u00b1164 pg\/mL). BP increased during cardiopulmonary exercise testing post-LVAD, but the magnitude of change was modest and comparable to the changes observed during the pre-LVAD cardiopulmonary exercise testing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Among patients with advanced heart failure with reduced ejection fraction, CF-LVAD implantation is associated with modest improvements in autonomic tone, but persistent reductions in cardiac baroreceptor sensitivity. Exercise-induced increases in BP are blunted. These findings shed new light on mechanisms for adverse events such as stroke, and persistent reductions in functional capacity, among patients supported by CF-LVADs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03078972.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.120.007448","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T19:00:30Z","timestamp":1611082830000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Impairments in Blood Pressure Regulation and Cardiac Baroreceptor Sensitivity Among Patients With Heart Failure Supported With Continuous-Flow Left Ventricular Assist Devices"],"prefix":"10.1161","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct03078972","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Christine","family":"Sailer","sequence":"first","affiliation":[{"name":"Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Edelmann","sequence":"additional","affiliation":[{"name":"University of Colorado-Denver (H.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cullen","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Medicine (C.B., P.G.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1226-716X","authenticated-orcid":true,"given":"Pedro","family":"Giro","sequence":"additional","affiliation":[{"name":"Department of Medicine (C.B., P.G.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-4411","authenticated-orcid":true,"given":"Matthew","family":"Babcock","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Medicine (M.B., W.K.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-0862","authenticated-orcid":true,"given":"Christine","family":"Swanson","sequence":"additional","affiliation":[{"name":"Department of Medicine-Endocrinology, Metabolism and Diabetes (C.S.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Spotts","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Schulte","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Pratt-Cordova","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Coe","sequence":"additional","affiliation":[{"name":"Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Beindorff","sequence":"additional","affiliation":[{"name":"Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Robert L.","family":"Page","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Services, Aurora (R.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3503-4203","authenticated-orcid":true,"given":"Amrut V.","family":"Ambardekar","sequence":"additional","affiliation":[{"name":"Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay D.","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (J.D.P.), University of Colorado Anschutz Medical Campus, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Kohrt","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Medicine (M.B., W.K.), University of Colorado Anschutz Medical Campus, Aurora."},{"name":"Clinical and Translational Research Center (M. 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