Improved Left Ventricular Function After Chronic Left Ventricular Unloading

Frazier, O.H.; Benedict, Claude R.; Radovančević, Branislav; Bick, Roger J.; Capek, P; Springer, W; Macris, Michael P.; Delgado, Reynolds M.; Buja, L. Maximilian

doi:10.1016/s0003-4975(96)00437-7

Cited by 337 publications

(181 citation statements)

References 16 publications

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“…On the other hand, it may be argued that myofibrillar alterations occur independently of the underlying etiology of HF, and may most likely be a consequence, rather than a primary cause, of the disease (57). Some recovery is achievable, as evidenced by data of patients having undergone left ventricular assist device support (165)(166)(167)(168)(169). However, despite impressive hemodynamic recovery, even after the duration of support from a left ventricular assist device, the morphological signs of persistent severe structural damage are evident in patients suffering from HF (170).…”

Section: Cardiac Hypertrophymentioning

confidence: 99%

Myofibrillar remodelling in cardiac hypertrophy, heart failure and cardiomyopathies

Macháčková¹,

Barta²,

Dhalla³

2006

Canadian Journal of Cardiology

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Section: Cardiac Hypertrophymentioning

confidence: 99%

Myofibrillar remodelling in cardiac hypertrophy, heart failure and cardiomyopathies

Macháčková¹,

Barta²,

Dhalla³

2006

Canadian Journal of Cardiology

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“…Cardiac transplantation 1 and mechanical support using left ventricular assist system (LVAS) implantation 2 have been well accepted as the ultimate lifesaving means of supporting these patients. However, these treatments have limitations such as donor shortages, rejection, infection for cardiac transplantation, 3 and durability for LVAS.…”

mentioning

confidence: 99%

Myocardial Regeneration Therapy for Heart Failure

et al. 2002

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Background — We hypothesized that transfection of the gene for human hepatocyte growth factor (hHGF) combined with cellular cardiomyoplasty might regenerate the impaired myocardium. Methods and Results — We used a ligation model of proximal left anterior descending coronary artery (LAD) of Lewis rats. Two weeks after LAD ligation, 3 different treatments were conducted: (1) neonatal rat cardiomyocytes group (10 6 cells, T group, n=11), (2) HVJ-liposomes bearing the hHGF gene group (H group, n=10), and (3) combined (T-H group, n=10). The injection site was the scar area of myocardial infarction. For control, culture medium was injected (C group, n=13). Echocardiography demonstrated that cardiac performance was significantly ameliorated in the T-H group 4 and 8 weeks after injection. Contrast echocardiography also showed a marked increase in myocardial perfusion in the T-H group but not in the other groups. In the T-H group, neovascularization and a marked reduction of fibrosis were observed histologically. In an immunohistochemical study, strong staining for β 1 -integrin, α-, and β-dystroglycan were found principally in the basement membrane of myocytes in the T-H group 8 weeks after transplantation, although there was weak immunoreactivity in the T group. Conclusions — hHGF gene transfection enhanced the cellular cardiomyoplasty possibly by stimulating angiogenesis, restoring the impaired ECM, and promoting the integration of the dissociated grafted myocytes. The combined effects might have lead to the improved cardiac performance. Thus, combined therapy may be a promising strategy for the treatment of heart failure caused by myocardial infarction.

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“…The Texas Heart Institute conducted a retrospective study comparing selected anatomic, physiologic, hemodynamic, histological, and biochemical parameters of the left ventricle before and after VAD support. Based on these parameters, they found that ventricular function did improve in patients after being supported by a VAD [19]. Several studies have also shown that unloading is associated with better myocyte function and the reversal of abnormal gene expressions; improved myocyte contractile properties and normalization of genes that regulate brain natriuretic peptide, calcium handling, tumor necrosis factor alpha and cytoskeleton proteins has been demonstrated [6][7][8][9][10].…”

Section: Myocardial Recovery Improvement In Indices Of Cardiac Functmentioning

confidence: 96%

“…However, several medical centers have reported instances in which BTT patients have recovered function of their heart while waiting for a transplant; many of these patients were able to be weaned from VAD support and remain device/transplant free [12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Recovery in BTT patients is a promising option; the patient is able to forego a transplant altogether, thereby avoiding the long-term complications associated with transplantation and opening up the availability of the organ for another patient on the waiting list.…”

Section: Bridge To Recoverymentioning

confidence: 99%

Clinical Decision Support System for Optimal Vad Weaning

et al. 2005

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The hybrid model, consisting of a 21-parameter health screening and a 3-tier evaluation of cardiac recovery, was the best predictor of outcome, predicting 90% true weans, 100% true transplants, 0% false weans and 10% false transplants. By objectively combing knowledge from experts and data, this study illustrates how a CDSS can facilitate the decision making processes for identifying VAD weaning candidates and promote responsible and widespread use of VADs for cardiac rehabilitation.iv

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Improved Left Ventricular Function After Chronic Left Ventricular Unloading

Cited by 337 publications

References 16 publications

Myofibrillar remodelling in cardiac hypertrophy, heart failure and cardiomyopathies

Myofibrillar remodelling in cardiac hypertrophy, heart failure and cardiomyopathies

Myocardial Regeneration Therapy for Heart Failure

Clinical Decision Support System for Optimal Vad Weaning

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