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Effect of Cerebral Flow Autoregulation Function on Cerebral Flow Rate Under Continuous Flow Left Ventricular Assist Device Support

Bozkurt, S; (2018) Effect of Cerebral Flow Autoregulation Function on Cerebral Flow Rate Under Continuous Flow Left Ventricular Assist Device Support. Artificial Organs 10.1111/aor.13148. (In press). Green open access

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Abstract

Neurological complications in continuous flow left ventricular assist device (CF‐LVAD) patients are the second‐leading risk of death after multi‐organ failure. They are associated with altered blood flow in the cardiovascular system because of CF‐LVAD support. Moreover, an impaired cerebral autoregulation function may also contribute to complications such as hyperperfusion in the cerebral circulation under mechanical circulatory support. The aim of this study is to evaluate the effect of cerebral autoregulatory function on cerebral blood flow rate under CF‐LVAD support. A lumped parameter model was used to simulate the cardiovascular system including the heart chambers, heart valves, systemic and pulmonary circulations and cerebral circulation which includes entire Circle of Willis. A baroreflex model was used to regulate the systemic arteriolar and cerebral vascular resistances and a model of the Micromed CF‐LVAD was used to simulate the pump dynamics at different operating speeds. Additionally, preserved and impaired cerebral autoregulatory functions were simulated in heart failure and under CF‐LVAD support. Cerebral blood flow rate was restored under CF‐LVAD support at 10 500 rpm pump operating speed which generated a similar arterial blood pressure and blood flow as in a healthy condition for the impaired cerebral autoregulatory function while the preserved cerebral autoregulatory function regulated the cerebral flow rate within a relatively low range for the applied pump operating speeds. Relatively low or high pump operating speeds may cause underpefusion or hyperperfusion for a failing cardiovascular system with impaired cerebral autoregulatory function under CF‐LVAD support which will contribute to the worsening of cerebral complications.

Type: Article
Title: Effect of Cerebral Flow Autoregulation Function on Cerebral Flow Rate Under Continuous Flow Left Ventricular Assist Device Support
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/aor.13148
Publisher version: https://onlinelibrary.wiley.com/doi/full/10.1111/a...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Left ventricular assist device, Continuous flow left ventricular assist devices, Cerebral flow, Cerebral autoregulatory function
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Childrens Cardiovascular Disease
URI: https://discovery.ucl.ac.uk/id/eprint/10048037
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