Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support

An In Vivo Study

Research output: Contribution to journalArticle

Abstract

Acquired von Willebrand Syndrome (AVWS) in patients undergoing continuous-flow left ventricular assist device support is due to the loss of von Willebrand factor (vWF) high molecular weight multimers (HMWMs) by shear-mediated mechanisms. We investigated whether reducing speed in vivo would mitigate the shear effect. In outpatients (n = 6) with a HeartMate II, pump speed was decreased to 8,000 rpm for 6 hours. At baseline (9,140 ± 189 rpm), patients had an AVWS as evidenced by low vWF activity:antigen ratios (0.58 ± 0.13, normal >0.7) and reduced HMWMs. After 6 hours, there was no significant change in either the vWF activity:antigen ratio or the HMWMs. Decreasing pump speed does not ameliorate AVWS.

Original languageEnglish (US)
Pages (from-to)e123-e125
JournalASAIO journal (American Society for Artificial Internal Organs : 1992)
Volume64
Issue number5
DOIs
StatePublished - Sep 1 2018

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von Willebrand Factor
Molecular Weight
Molecular weight
Antigens
Left ventricular assist devices
Pumps
Heart-Assist Devices
Outpatients

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Cite this

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title = "Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study",
abstract = "Acquired von Willebrand Syndrome (AVWS) in patients undergoing continuous-flow left ventricular assist device support is due to the loss of von Willebrand factor (vWF) high molecular weight multimers (HMWMs) by shear-mediated mechanisms. We investigated whether reducing speed in vivo would mitigate the shear effect. In outpatients (n = 6) with a HeartMate II, pump speed was decreased to 8,000 rpm for 6 hours. At baseline (9,140 ± 189 rpm), patients had an AVWS as evidenced by low vWF activity:antigen ratios (0.58 ± 0.13, normal >0.7) and reduced HMWMs. After 6 hours, there was no significant change in either the vWF activity:antigen ratio or the HMWMs. Decreasing pump speed does not ameliorate AVWS.",
author = "Omar Saeed and Sabarivinoth Rangasamy and {Reyes Gil}, Morayma and Goldstein, {Daniel J.} and Billett, {Henny H.} and Jorde, {Ulrich P.} and Patel, {Snehal R.}",
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