Journal of Cardiac Failure
Volume 16, Issue 2 , Pages 99-105 , February 2010

Left Ventricular Remodeling and Myocardial Recovery on Mechanical Circulatory Support

  • Marc A. Simon, MD, MS

      Affiliations

    • Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA
    • Corresponding Author InformationReprint requests: Marc A Simon, MD, MS, S-554 Scaife Hall, 200 Lothrop Street, Pittsburgh, PA 15213. Tel: (412) 647-7168; Fax: (412) 647-0595.
    • ,
  • Brian A. Primack, MD, EDM, MS

      Affiliations

    • Departments of Medicine and Pediatrics, University of Pittsburgh, Pittsburgh, PA
    • Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Jeffrey Teuteberg, MD

      Affiliations

    • Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Robert L. Kormos, MD

      Affiliations

    • Heart, Lung, Esophageal Surgery Institute, University of Pittsburgh, Pittsburgh, PA
    • Artificial Heart Program, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Christian Bermudez, MD

      Affiliations

    • Heart, Lung, Esophageal Surgery Institute, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Yoshiya Toyoda, MD, PhD

      Affiliations

    • Heart, Lung, Esophageal Surgery Institute, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Hemal Shah, MD

      Affiliations

    • Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA
    • ,
  • John Gorcsan III, MD

      Affiliations

    • Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Dennis M. McNamara, MD

      Affiliations

    • Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA

Received 8 May 2009 ,Revised 8 October 2009 ,Accepted 8 October 2009.

References 

  1. Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345:1435–1443
  2. McCarthy PM, Smedira NO, Vargo RL, Goormastic M, Hobbs RE, Starling RC, et al. One hundred patients with the HeartMate left ventricular assist device: evolving concepts and technology. J Thorac Cardiovasc Surg. 1998;115:904–912
  3. Frazier OH, Rose EA, McCarthy P, Burton NA, Tector A, Levin H, et al. Improved mortality and rehabilitation of transplant candidates treated with a long-term implantable left ventricular assist system. Ann Surg. 1995;222:327–336
  4. Kavarana MN, Sinha P, Naka Y, Oz MC, Edwards NM. Mechanical support for the failing cardiac allograft: a single-center experience. J Heart Lung Transplant. 2003;22:542–547
  5. Gorcsan J, Severyn D, Murali S, Kormos RL. Non-invasive assessment of myocardial recovery on chronic left ventricular assist device: results associated with successful device removal. J Heart Lung Transplant. 2003;22:1304–1313
  6. Farrar DJ, Holman WR, McBride LR, Kormos RL, Icenogle TB, Hendry PJ, et al. Long-term follow-up of Thoratec ventricular assist device bridge-to-recovery patients successfully removed from support after recovery of ventricular function. J Heart Lung Transplant. 2002;21:516–521
  7. Maybaum S, Stockwell P, Naka Y, Catanese K, Flannery M, Fisher P, et al. Assessment of myocardial recovery in a patient with acute myocarditis supported with a left ventricular assist device: a case report. J Heart Lung Transplant. 2003;22:202–209
  8. Khan T, Delgado RM, Radovancevic B, Torre-Amione G, Abrams J, Miller K, et al. Dobutamine stress echocardiography predicts myocardial improvement in patients supported by left ventricular assist devices (LVADs): hemodynamic and histologic evidence of improvement before LVAD explantation. J Heart Lung Transplant. 2003;22:137–146
  9. Mancini DM, Beniaminovitz A, Levin H, Catanese K, Flannery M, DiTullio M, et al. Low incidence of myocardial recovery after left ventricular assist device implantation in patients with chronic heart failure. Circulation. 1998;98:2383–2389
  10. Hetzer R, Muller JH, Weng Y, Meyer R, Dandel M. Bridging-to-recovery. Ann Thorac Surg. 2001;71:S109–S113
  11. Frazier OH, Delgado RM, Scroggins N, Odegaard P, Kar B. Mechanical bridging to improvement in severe acute “nonischemic, nonmyocarditis” heart failure. Congest Heart Fail. 2004;10:109–113
  12. Birks EJ, Tansley PD, Hardy J, George RS, Bowles CT, Burke M, et al. Left ventricular assist device and drug therapy for the reversal of heart failure. N Engl J Med. 2006;355:1873–1884
  13. Bartling B, Milting H, Schumann H, Darmer D, Arusoglu L, Koerner MM, et al. Myocardial gene expression of regulators of myocyte apoptosis and myocyte calcium homeostasis during hemodynamic unloading by ventricular assist devices in patients with end-stage heart failure. Circulation. 1999;100(19 Suppl):II216–II223
  14. Milting H, Bartling B, Schumann H, El-Banayosy A, Wlost S, Ruter F, et al. Altered levels of mRNA of apoptosis-mediating genes after mid-term mechanical ventricular support in dilative cardiomyopathy–first results of the Halle Assist Induced Recovery Study (HAIR). Thorac Cardiovasc Surg. 1999;47:48–50
  15. James KB, McCarthy PM, Thomas JD, Vargo RL, Hobbs RE, Sapp S, et al. Effect of the implantable left ventricular assist device on neuroendocrine activation in heart failure. Circulation. 1995;92:II191–II195
  16. Milting H, El Banayosy A, Kassner A, Fey O, Sarnowski P, Arusoglu L, et al. The time course of natriuretic hormones as plasma markers of myocardial recovery in heart transplant candidates during ventricular assist device support reveals differences among device types. J Heart Lung Transplant. 2001;20:949–955
  17. Terracciano CM, Hardy J, Birks EJ, Khaghani A, Banner NR, Yacoub MH. Clinical recovery from end-stage heart failure using left-ventricular assist device and pharmacological therapy correlates with increased sarcoplasmic reticulum calcium content but not with regression of cellular hypertrophy. Circulation. 2004;109:2263–2265
  18. Chaudhary KW, Rossman EI, Piacentino V, Kenessey A, Weber C, Gaughan JP, et al. Altered myocardial Ca2+ cycling after left ventricular assist device support in the failing human heart. J Am Coll Cardiol. 2004;44:837–845
  19. Kucuker SA, Stetson SJ, Becker KA, Akgul A, Loebe M, Lafuente JA, et al. Evidence of improved right ventricular structure after LVAD support in patients with end-stage cardiomyopathy. J Heart Lung Transplant. 2004;23:28–35
  20. Torre-Amione G, Stetson SJ, Youker KA, Durand JB, Radovancevic B, Delgado RM, et al. Decreased expression of tumor necrosis factor-alpha in failing human myocardium after mechanical circulatory support: a potential mechanism for cardiac recovery. Circulation. 1999;100:1189–1193
  21. Goldstein DJ, Moazami N, Seldomridge JA, Laio H, Ashton RC, Naka Y, et al. Circulatory resuscitation with left ventricular assist device support reduces interleukins 6 and 8 levels. Ann Thorac Surg. 1997;63:971–974
  22. Barbone A, Holmes JW, Heerdt PM, The AH, Naka Y, Joshi N, et al. Comparison of right and left ventricular responses to left ventricular assist device support in patients with severe heart failure: a primary role of mechanical unloading underlying reverse remodeling. Circulation. 2001;104:670–675
  23. Bruckner BA, Stetson SJ, Perez-Verdia A, Youker KA, Radovancevic B, Connelly JH, et al. Regression of fibrosis and hypertrophy in failing myocardium following mechanical circulatory support. J Heart Lung Transplant. 2001;20:457–464
  24. Zafeiridis A, Jeevanandam V, Houser SR, Margulies KB. Regression of cellular hypertrophy after left ventricular assist device support. Circulation. 1998;98:656–662
  25. Simon MA, Kormos RL, Murali S, Nair P, Heffernan M, Gorcsan J, et al. Myocardial recovery using ventricular assist devices: prevalence, clinical characteristics, and outcomes. Circulation. 2005;112(9 Suppl):I32–I36
  26. Potapov EV, Loforte A, Weng Y, Jurmann M, Pasic M, Drews T, et al. Experience with over 1000 implanted ventricular assist devices. J Card Surg. 2008;23:185–194
  27. Starling RC, Cooper LC, Dec GW, Boehmer J, Liu L, Pauly P, et al. Left ventricular diameter predicts recovery in acute cardiomyopathy: results of the IMAC 2 trial. Circulation. 2007;116(16 Suppl):II-671
  28. Dandel M, Weng Y, Siniawski H, Potapov E, Lehmkuhl HB, Hetzer R. Long-term results in patients with idiopathic dilated cardiomyopathy after weaning from left ventricular assist devices. Circulation. 2005;112(9 Suppl):I37–I45
  29. Sheppard R, Bedi M, Kubota T, Semigran MJ, Dec W, Holubkov R, et al. Myocardial expression of fas and recovery of left ventricular function in patients with recent-onset cardiomyopathy. J Am Coll Cardiol. 2005;46:1036–1042
  30. Bedi MS, Alvarez RJ, Kubota T, Sheppard R, Kormos RL, Siegenthaler MP, et al. Myocardial Fas and Cytokine expression in end-stage heart failure: impact of LVAD support. Clin Translational Sci. 2008;1:245–248
  31. Garcia S, Kandar F, Boyle A, Colvin-Adams M, Lliao K, Joyce L, et al. Effects of pulsatile- and continuous-flow left ventricular assist devices on left ventricular unloading. J Heart Lung Transplant. 2008;27:261–267
  32. Klotz S, Deng MC, Stypmann J, Roetker J, Wilhelm MJ, Hammel D, et al. Left ventricular pressure and volume unloading during pulsatile versus nonpulsatile left ventricular assist device support. Ann Thorac Surg. 2004;77:143–149discussion 149–150
  33. Haft J, Armstrong W, Dyke DB, Aaronson KD, Koelling TM, Farrar DJ, et al. Hemodynamic and exercise performance with pulsatile and continuous-flow left ventricular assist devices. Circulation. 2007;116(11 Suppl):I8–15
  34. Thohan V, Stetson SJ, Nagueh SF, Rivas-Gotz C, Koerner MM, Lafuente JA, et al. Cellular and hemodynamics responses of failing myocardium to continuous flow mechanical circulatory support using the DeBakey-Noon left ventricular assist device: a comparative analysis with pulsatile-type devices. J Heart Lung Transplant. 2005;24:566–575

 Dr. Simon is supported by the NIH Roadmap Multidisciplinary Clinical Research Career Development Award (KL2 RR024154). Dr. McNamara is supported by NIH Award R01 HL75038, and K24 HL069912. Dr. Primack is supported by a grant from the National Cancer Institute (K07-CA114315) and a grant from the Maurice Falk Foundation. Dr. Gorcsan is supported in part by NIH award K24 HL04503 and R01 HL086918. Dr. Kormos is on the medical advisory boards of Thoratec Corporation & World Heart Corporation. No other authors report relationships with industry.

PII: S1071-9164(09)01128-2

doi: 10.1016/j.cardfail.2009.10.018

Journal of Cardiac Failure
Volume 16, Issue 2 , Pages 99-105 , February 2010

Article Tools

* Image Usage & Resolution