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How can we reduce regional left ventricular wall stress and improve ejection fraction in heart failure patients?

Urgert, Thomas (2019) How can we reduce regional left ventricular wall stress and improve ejection fraction in heart failure patients?

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Abstract:Introduction Heart failure with reduced Ejection Fraction (HFrEF) is a progressive disease. Increased left ventricular wall stress in HFrEF patients is a main contributor for disease progression. The aim of this study is to quantify regional left ventricular wall stress during a full cardiac cycle in dilated and physiological hearts. Methods Continuous 3D transesophageal echocardiography and left intraventricular pressure were obtained in 9 patients during cardiac surgery to determine the regional wall stress. Based on ejection fraction and end-diastolic diameter a division between physiological and HFrEF ventricles were made. Results Significant differences for the lower segments of the ventricle were found at peak systole and end systole. Significant correlations between end-systolic, peak systolic, end-diastolic wall stress and cyclic variation curvature and wall thickening were found. Conclusion Full cardiac cyclic left ventricular regional wall stress was successfully obtained during cardiac surgery. The current study provides insight into the differences in regional wall stress between physiological and impaired functioning ventricles. Future work should develop minimal invasive devices with patient-specific full cardiac cycle support to lower the regional wall stress.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:https://purl.utwente.nl/essays/79922
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