Bridge to recovery with the use of left ventricular assist device and clenbuterol.
Treatment of heart failure using a left ventricular assist device (LVAD) is emerging as one of the most rapidly expanding areas. These devices are now used to treat patients with terminal heart failure not only as a bridge to transplantation but also for a bridge to recovery in certain carefully selected patients. More recently we have developed a strategy of combining LVAD support with pharmacologic therapies to produce maximal reverse remodeling followed by the induction of physiologic cardiac hypertrophy using clenbuterol, a selective beta2-adrenergic receptor agonist (the Harefield protocol). The purpose of this communication is to provide a brief review of remodeling, reverse remodeling, and the rationale for the use of clenbuterol to enhance the efficacy of the LVAD.
Hon
Jimmy K F
JK
Department of Cardiothoracic Surgery, National Heart and Lung Institute at Royal Brompton and Harefield Hospitals, London, United Kingdom. j.hon@ic.ac.uk
Yacoub
Magdi H
MH
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D002976:Clenbuterol / Q000627:therapeutic use*; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans
D000318:Adrenergic beta-Agonists; D002976:Clenbuterol