Neurovascular consequences of non-pulsatile flow from left ventricular assist devices

Ended Project Grant Awarded Last action

Award ID
R01NS121364
Recipient
Awarding agency
Obligated
$6,334,086

Award facts

Completion date
Place of performance
New York, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
This project will be an observational study with the primary goal to examine the consequences of non-pulsatile flow under continuous flow left ventricular assisted devices (CF-lvad) on the cerebral circulation. The public health burden from congestive heart failure (CHF) is substantial and few treatment options are available to those patients at the end-stage. Unfortunately, cardiac transplantation is not widely available and many of these patients rely on left ventricular assist devices for circulatory support. The newest generation devices are designed for durability and therefore deliver non-pulsatile flow. Despite improvements in CHF mortality, CF- lvad is associated with multiple complications that are hypothesized to originate from the impact of non-pulsatile flow on arterial endothelium, notably gastrointestinal bleeding, and poor gains in exercise tolerance. CF-lvad patients develop unusually high rates of ischemic stroke with hemorrhagic transformation (isht), one of the leading causes of death in these patients. Isht in the general population results from microcirculatory dysfunction with disruption of the blood brain barrier (BBB) and cerebral endothelium. The impact of non-pulsatile flow on the BBB and cerebral endothelium has not yet been studied in human CF-lvad patients, in part due to the lack of markers specific to the cerebral circulation. In aim 1A we will perform transcranial doppler (TCD) before and after CF-lvad implantation to measure the breath holding index as a physiological marker of cerebral autoregulation an important function of cerebral endothelium. In aim 1B we will examine the impact of non- pulsatile flow on the blood retina barrier (anatomically similar to the BBB) with optical coherence tomography angiography and retinal doppler. In aim 2 we will examine changes in cognition in CF-lvad participants before and after surgery and versus controls. The overall goals of this proposal will be to identify physiological and functional changes which occur in the cerebral circulation under non-pulsatile flow which will allow for improved risk stratification and tailored treatment approaches in the application of CF-lvad in end-stage CHF.

Transactions

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Subawards

Subrecipient Amount Awarded
Gottfried Wilhelm Leibniz Universitaet Hannover Dr Stöhr will train personnel in the ultrasound acquisition of various arterial beds, including the central retinal artery and the common carotid arteries. In… $8,386
Cardiff Metropolitan University DR barry mcdonnell, CO-investigator (0.6 calendar month's year's 1-5)DR barry mcdonnell 's international expertise in the assessment of arterial stiffnes's… $8,383
Gottfried Wilhelm Leibniz Universitaet Hannover Dr Stöhr will train personnel in the ultrasound acquisition of various arterial beds, including the central retinal artery and the common carotid arteries.… $8,192
Cardiff Metropolitan University Dr Barry McDonnell, Co-Investigator (0.6 calendar months years 1-5) Dr Barry McDonnell’s international expertise in the assessment of arterial… $8,358

Quick answers

Who received award R01NS121364?

R01NS121364 was awarded to The Trustees Of Columbia University In The City Of New York by National Institute of Neurological Disorders and Stroke (National Institutes of Health) on January 1, 2022.

How much is award R01NS121364 worth?

$6,334,086 has been obligated on R01NS121364.

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