Left ventricular assist device-induced reverse ventricular remodeling.
Left ventricular assist devices provide chronic pressure and volume unloading of the dilated left ventricle in patients with end-stage heart failure. This is associated with reverse structural remodeling (normalization of the passive pressure-volume relationship), reverse molecular remodeling (increased expression of several genes involved in calcium metabolism that are down-regulated in heart failure), improved baseline contractility, and improved contractile response to increased heart rate and to beta-agonist stimulation. These findings indicate the profound degree of recovery of myocardial properties in hearts previously considered to have invincible end-stage heart failure.
Department of Medicine, Columbia University, New York, NY 10032, USA. db59@columbia.edu
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D
Burkhoff
J W
JW
Holmes
J
J
Madigan
A
A
Barbone
M C
MC
Oz
D002118:Calcium / Q000378:metabolism; D000252:Calcium-Transporting ATPases / Q000378:metabolism; D004452:Echocardiography; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D006353:Heart-Assist Devices; D006801:Humans; D009200:Myocardial Contraction; D009206:Myocardium / Q000378:metabolism; D019831:Sodium-Calcium Exchanger / Q000378:metabolism; D017725:Ventricular Pressure; D020257:Ventricular Remodeling / Q000502:physiology
D019831:Sodium-Calcium Exchanger; D000252:Calcium-Transporting ATPases; D002118:Calcium