Association between splenic volume and pulsatility index in patients with left ventricular assist devices

Hiroaki Hiraiwa, Takahiro Okumura, Akinori Sawamura, Toru Kondo, Shingo Kazama, Yuki Kimura, Naoki Shibata, Yoshihito Arao, Hideo Oishi, Hiroo Kato, Tasuku Kuwayama, Shogo Yamaguchi, Kenji Furusawa, Ryota Morimoto, Kazuro Fujimoto, Masato Mutsuga, Akihiko Usui, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

The spleen serves as a blood volume reservoir for systemic volume regulation in heart failure (HF) patients. Changes are seen in spleen size in advanced HF patients after left ventricular assist device (LVAD) implantation. The pulsatility index (PI) is an indicator of native heart contractility with hemodynamic changes in patients using LVAD. We hypothesized that the splenic volume was associated with the PI, reflecting the hemodynamics in advanced HF patients with LVADs. Herein, we investigated the relationship between splenic volume and PI in these patients. Forty-four patients with advanced HF underwent implantation of HeartMate II® (Abbott, Chicago, IL, USA) as a bridge to heart transplantation at the Nagoya University Hospital between October 2013 and June 2019. The data of 27 patients (21 men, median age 46 years) were analyzed retrospectively. All patients underwent blood tests, echocardiography, right heart catheterization, and computed tomography (CT). Spleen size was measured via CT volumetry; the splenic volume (median: 190 mL) correlated with right arterial pressure (r = 0.431, p = 0.025) and pulmonary capillary wedge pressure (r = 0.384, p = 0.048). On multivariate linear regression analysis, the heart rate (β = −0.452, p = 0.003), pump power (β = −0.325, p = 0.023), and splenic volume (β = 0.299, p = 0.038) were independent determinants of PI. The splenic volume was associated with PI, reflecting the cardiac preload in advanced HF patients with LVADs. Thus, spleen measurement using CT may help estimate the systemic volume status and understand the hemodynamic conditions in LVAD patients.

Original languageEnglish
Pages (from-to)282-287
Number of pages6
JournalInternational Journal of Artificial Organs
Volume44
Issue number4
DOIs
Publication statusPublished - 04-2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

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