Myocardial Recovery During Mechanical Circulatory Support: Cellular, Molecular, Genomic and Organ Levels

Overview

Journal Heart Lung Vessel

Specialty Anesthesiology

Date 2015 Jul 10

PMID 26157737

Citations 4

Authors

Michael Dandel

Roland Hetzer

Affiliations

Soon will be listed here.

Abstract

Mechanical circulatory support is a life-saving therapy that will become either a bridge-to-transplantation or definitive therapy if heart transplantation is not possible. Failing hearts supported by a ventricular assist device were often found to recover at molecular and cellular level but translation of these changes into functionally-stable cardiac recovery allowing long-term heart transplantation/ventricular assist device-free outcomes after weaning from ventricular assist device is relatively rare and related to the etiology, severity and duration of myocardial damage. The reason for the discrepancy between high recovery rates on the cellular and molecular levels and the low rate of cardiac recovery allowing ventricular assist device explantation is unknown.

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References

McBride L, Naunheim K, Fiore A, Moroney D, Swartz M . Clinical experience with 111 thoratec ventricular assist devices. Ann Thorac Surg. 1999; 67(5):1233-8; discussion 1238-9. DOI: 10.1016/s0003-4975(99)00246-5. View

Akhter S, Eckhart A, Rockman H, Shotwell K, Lefkowitz R, Koch W . In vivo inhibition of elevated myocardial beta-adrenergic receptor kinase activity in hybrid transgenic mice restores normal beta-adrenergic signaling and function. Circulation. 1999; 100(6):648-53. DOI: 10.1161/01.cir.100.6.648. View

Hetzer R, Muller J, Weng Y, Wallukat G, Spiegelsberger S, Loebe M . Cardiac recovery in dilated cardiomyopathy by unloading with a left ventricular assist device. Ann Thorac Surg. 1999; 68(2):742-9. DOI: 10.1016/s0003-4975(99)00542-1. View

Francis G, Anwar F, Bank A, Kubo S, Jessurun J . Apoptosis, Bcl-2, and proliferating cell nuclear antigen in the failing human heart: observations made after implantation of left ventricular assist device. J Card Fail. 2000; 5(4):308-15. DOI: 10.1016/s1071-9164(99)91335-0. View

Baba H, Grabellus F, August C, Plenz G, Takeda A, Tjan T . Reversal of metallothionein expression is different throughout the human myocardium after prolonged left-ventricular mechanical support. J Heart Lung Transplant. 2000; 19(7):668-74. DOI: 10.1016/s1053-2498(00)00074-7. View

Heerdt P, Holmes J, Cai B, Barbone A, Madigan J, Reiken S . Chronic unloading by left ventricular assist device reverses contractile dysfunction and alters gene expression in end-stage heart failure. Circulation. 2000; 102(22):2713-9. DOI: 10.1161/01.cir.102.22.2713. View

Hetzer R, Muller J, Weng Y, Meyer R, Dandel M . Bridging-to-recovery. Ann Thorac Surg. 2001; 71(3 Suppl):S109-13; discussion S114-5. DOI: 10.1016/s0003-4975(00)02638-2. View

Li Y, Feng Y, McTiernan C, Pei W, Moravec C, Wang P . Downregulation of matrix metalloproteinases and reduction in collagen damage in the failing human heart after support with left ventricular assist devices. Circulation. 2001; 104(10):1147-52. DOI: 10.1161/hc3501.095215. View

de Jonge N, van Wichen D, Schipper M, Lahpor J, Gmelig-Meyling F, Robles de Medina E . Left ventricular assist device in end-stage heart failure: persistence of structural myocyte damage after unloading. An immunohistochemical analysis of the contractile myofilaments. J Am Coll Cardiol. 2002; 39(6):963-9. DOI: 10.1016/s0735-1097(02)01713-8. View

10.

Farrar D, Holman W, McBride L, Kormos R, Icenogle T, Hendry P . 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(5):516-21. DOI: 10.1016/s1053-2498(01)00408-9. View

11.

Blaxall B, Tschannen-Moran B, Milano C, Koch W . Differential gene expression and genomic patient stratification following left ventricular assist device support. J Am Coll Cardiol. 2003; 41(7):1096-106. DOI: 10.1016/s0735-1097(03)00043-3. View

12.

Terracciano C, Hardy J, Birks E, Khaghani A, Banner N, Yacoub M . 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(19):2263-5. DOI: 10.1161/01.CIR.0000129233.51320.92. View

13.

Rodrigue-Way A, Burkhoff D, Geesaman B, Golden S, Xu J, Pollman M . Sarcomeric genes involved in reverse remodeling of the heart during left ventricular assist device support. J Heart Lung Transplant. 2005; 24(1):73-80. DOI: 10.1016/j.healun.2003.10.016. View

14.

Klotz S, Barbone A, Reiken S, Holmes J, Naka Y, Oz M . Left ventricular assist device support normalizes left and right ventricular beta-adrenergic pathway properties. J Am Coll Cardiol. 2005; 45(5):668-76. DOI: 10.1016/j.jacc.2004.11.042. View

15.

Klotz S, Foronjy R, Dickstein M, Gu A, Garrelds I, Danser A . Mechanical unloading during left ventricular assist device support increases left ventricular collagen cross-linking and myocardial stiffness. Circulation. 2005; 112(3):364-74. DOI: 10.1161/CIRCULATIONAHA.104.515106. View

16.

Wohlschlaeger J, Schmitz K, Schmid C, Schmid K, Keul P, Takeda A . Reverse remodeling following insertion of left ventricular assist devices (LVAD): a review of the morphological and molecular changes. Cardiovasc Res. 2005; 68(3):376-86. DOI: 10.1016/j.cardiores.2005.06.030. View

17.

Simon M, Kormos R, Murali S, Nair P, Heffernan M, Gorcsan J . Myocardial recovery using ventricular assist devices: prevalence, clinical characteristics, and outcomes. Circulation. 2005; 112(9 Suppl):I32-6. DOI: 10.1161/CIRCULATIONAHA.104.524124. View

18.

Dandel M, Weng Y, Siniawski H, Potapov E, Lehmkuhl H, Hetzer R . Long-term results in patients with idiopathic dilated cardiomyopathy after weaning from left ventricular assist devices. Circulation. 2005; 112(9 Suppl):I37-45. DOI: 10.1161/CIRCULATIONAHA.104.525352. View

19.

Birks E, Hall J, Barton P, Grindle S, Latif N, Hardy J . Gene profiling changes in cytoskeletal proteins during clinical recovery after left ventricular-assist device support. Circulation. 2005; 112(9 Suppl):I57-64. DOI: 10.1161/CIRCULATIONAHA.104.526137. View

20.

Pandalai P, Bulcao C, Merrill W, Akhter S . Restoration of myocardial beta-adrenergic receptor signaling after left ventricular assist device support. J Thorac Cardiovasc Surg. 2006; 131(5):975-80. DOI: 10.1016/j.jtcvs.2006.01.027. View