Magnitude and Time Course of Changes Induced by Continuous-Flow Left Ventricular Assist Device Unloading in Chronic Heart Failure: Insights Into Cardiac Recovery

摘要: Objectives This study sought to prospectively investigate the longitudinal effects of continuous-flow left ventricular assist device (LVAD) unloading on myocardial structure and systolic diastolic function. Background The magnitude, timeline, sustainability changes induced by LVAD function failing human heart are unknown. Methods Eighty consecutive patients with clinical characteristics consistent chronic failure requiring implantation a were enrolled. Serial echocardiograms (at 1, 2, 3, 4, 6, 9, 12 months) right catheterizations performed after implant. Cardiac recovery was assessed basis improvement in indices echocardiography that sustained during turn-down studies. Results After 6 months unloading, 34% had relative LV ejection fraction increase above 50% 19% patients, both ischemic nonischemic, achieved an ≥40%. improved as early 30 days, greatest degree mechanical persisted over 1-year follow up. parameters also days this time. end-diastolic end-systolic volumes decreased (113 vs. 77 ml/m2, p Conclusions Continuous-flow subset largely completed within months, no evidence subsequent regression.