The response of the failing heart to chronic mechanical unloading.
OBJECTIVE
The authors present a comprehensive analysis of the evidence in support of improvements at the cellular, structural, and hemodynamic levels after left ventricular assist device support.


RESULTS
The use of left ventricular assist devices as a strategy to bridge patients to cardiac transplantation and, more recently, as a form of destination therapy has provided a great opportunity to study failing myocardium at various time points. Specifically, myocardial samples can be obtained from patients at the time of left ventricular assist device implantation and again at explant, thereby allowing comparisons between paired samples of failing myocardium obtained before and after mechanical unloading.


CONCLUSIONS
A body of knowledge has been generated that illustrates the ability of the myocardium to "heal." This information may give us better insight into cellular and molecular mechanisms of heart failure and potential new therapies for patients with end-stage heart failure.
Wallace
Cynthia K
CK
Methodist DeBakey Heart Center, The Winter's Center for Heart Failure Research and the Gene and Judy Campbell Laboratories for Transplantation Research, Baylor College of Medicine, Houston, Texas 77030, USA.
Koerner
Michael M
MM
Thohan
Vinay
V
Loebe
Matthias
M
Lafuente
Javier
J
Noon
George P
GP
Torre-Amione
Guillermo
G
D016189:Dystrophin / Q000378:metabolism; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology*; D006353:Heart-Assist Devices; D006801:Humans; D032383:Myocytes, Cardiac / Q000378:metabolism / Q000473:pathology*; D020257:Ventricular Remodeling
D016189:Dystrophin