Traveling outside the heart Nov 14.pptx

1、,Travelling Outside the Heart:Beyond Intra-Thoracic Hemodynamics,Jennifer Cowger,MD,MSSection Head,Advanced Heart Failure TherapiesHenry Ford HealthDetroit,Michigan,Dr Cowger has the following disclosures as of November 2025:Abbott,Inc:Steering Committee for Tendyne and Cephea valves,Advisory Board

2、and National PI for HM3 TEAM-HF trialAstraZeneca:study leadership panel for BALANCE D HF(end 2025)Berlin Heart:DSMB member for EXCOR Active Driver pediatric VADBioVentrix:Consultant and speaker(end 2023)BiVACOR:DSMBBrioHealth Solutions:Consultant.National leadership panel for BrioVAD INNOVATE trialC

3、orWave:Consultant(unpaid to date)Endotronix,Inc:Steering committee member(unpaid)for Proactive HF trialMedtronic,Inc:National PI and Steering Committee HVAD DT PASNuwellis:Steering committee member for Restore-HF trial(end 2025)Phope:Consultant(unpaid to date)Procyrion,Inc:Advisor and Steering commi

4、ttee member for pilot and pivotal trials;stock optionsPumpin Heart:Consultant(unpaid to date)TenNor Therapeutics:ConsultantZoll:Speaker for fellows conferences,HF and Shock management goal:End organ survivalCardiac output and blood pressure are necessary but not sufficient for end-organ survivalMark

5、ers of macrocirculationMicrocirculation:“business end”of the target organ,Cooper,Front.Vet.Sci.,2021;8:,Resistance vessel,Capacitance vessel,Terminal vascular network of vessels 20-50 m in target organsO2 delivery and waste removal,Patterns of Altered Microcirculatory Flow,Guven,Blood purif 2020;49:

6、143-50,Type 1:RBC become stagnant and lose O2 carrying capacity during SIRS with reduce tissue oxygenation from shuntingType 2:Decrease in O2 carrying potential due to hemodilution or bleedingType 3:RBC stasis due to increased resistance or high CVPType 4:Increase O2 diffusion distance due to edema(