Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study

Omar Saeed; Sabarivinoth Rangasamy; Morayma Reyes Gil; Daniel J. Goldstein; Henny H. Billett; Ulrich P. Jorde; Snehal R. Patel

doi:10.1097/MAT.0000000000000831

Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study

Omar Saeed, Sabarivinoth Rangasamy, Morayma Reyes Gil, Daniel J. Goldstein, Henny H. Billett, Ulrich P. Jorde, Snehal R. Patel

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

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 language	English
Pages (from-to)	E123-E125
Journal	ASAIO Journal
Volume	64
Issue number	5
DOIs	https://doi.org/10.1097/MAT.0000000000000831
State	Published - 1 Sep 2018
Externally published	Yes

Keywords

Bleeding
Rotor speed
VWF deficiency

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10.1097/MAT.0000000000000831

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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.",

keywords = "Bleeding, Rotor speed, VWF deficiency",

author = "Omar Saeed and Sabarivinoth Rangasamy and Gil, \{Morayma Reyes\} and Goldstein, \{Daniel J.\} and Billett, \{Henny H.\} and Jorde, \{Ulrich P.\} and Patel, \{Snehal R.\}",

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doi = "10.1097/MAT.0000000000000831",

language = "English",

volume = "64",

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T1 - Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support

T2 - An In Vivo Study

AU - Saeed, Omar

AU - Rangasamy, Sabarivinoth

AU - Gil, Morayma Reyes

AU - Goldstein, Daniel J.

AU - Billett, Henny H.

AU - Jorde, Ulrich P.

AU - Patel, Snehal R.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - 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.

AB - 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.

KW - Bleeding

KW - Rotor speed

KW - VWF deficiency

UR - https://www.scopus.com/pages/publications/85060531220

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DO - 10.1097/MAT.0000000000000831

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SN - 1058-2916

VL - 64

SP - E123-E125

JO - ASAIO Journal

JF - ASAIO Journal

IS - 5

ER -

Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study

Abstract

Keywords

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