Pressure-strain loops unveil hemodynamics behind mechanical circulatory support systems

Abstract Background Mechanical circulatory support (MCS) systems are increasingly employed in critical hemodynamic states, such as cardiogenic shock and end-stage heart failure. A thorough understanding of the complex interactions occurring between heart, vasculature device is essential to optimize patient's management. Purpose This study aimed explore profile patients under MCS using a non-invasive method based on pressure-strain analysis. Methods Consecutive admitted cardiological intensive care unit (CICU) from August 2021 January 2022 undergoing different positioning/implantation were retrospectively reviewed. Patients without useful echocardiographic exam and/or arterial blood pressure invasive measurement at time echocardiography excluded. Myocardial work analysis by Speckle Tracking Echocardiography (STE) was performed these patients. Results 3 with intra-aortic balloon pump (IABP), 2 durable left ventricular assist (dLVAD), temporaneous ventricle (LV)-to-aortic pump, 1 patient extracorporeal membrane oxygenation (ECMO) ECMO IABP included. The use shifted curve rightward downward. Global index (GWI) global wasted (GWW) decreased after positioning, whereas efficiency (GWE) increased. continuous-flow LV-to-aortic pumps, whether or long-term induced significant change loop, shift towards triangular shape. positioning alone resulted narrowing decrease GWI GWE an increase GWW mean pressure. combined used widened loop improved GWE. Conclusions Pressure-strain loops unveil variations mechanical systems. Thus, myocardial could be monitor ventricular-arterial-device coupling therefore guide tailored Funding Acknowledgement Type funding sources: None.