title: Molecular changes occurring during reverse remodelling following left ventricular assist device support.
abstract: Remodelling is the central feature that occurs in the progression of heart failure. However, unloading of the heart with a left ventricular assist device (LVAD) can lead to reversal of many of the remodelling changes even in patients with advanced heart failure. LVAD unloading can also lead to improved myocardial function and this improvement can be sufficient to allow removal of the device leaving the patient to lead a normal life. We review the molecular changes that have been demonstrated with LVAD unloading in patients bridged to transplantation and also those that have occurred in the myocardium of patients that have recovered their myocardial function enough to have the device removed. Changes in both the myocyte and the matrix are reviewed.
authors.affiliation: Transplantation and Mechanical Support, University of Louisville, 201 Abraham Flexner Way, Louisville, KY 40222, USA. e.birks@imperial.ac.uk
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Birks
authors.forename: Robert S
authors.initials: RS
authors.lastname: George
mesh_terms: D000818:Animals; D020878:Device Removal; D005109:Extracellular Matrix / Q000378:metabolism*; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D032383:Myocytes, Cardiac / Q000378:metabolism*; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D020257:Ventricular Remodeling
references.citation: Heart. 1997 Sep;78(3):278-84
references.pmid: 9391291
references.citation: J Heart Lung Transplant. 2006 Sep;25(9):1091-8
references.pmid: 16962471
references.citation: Prog Biophys Mol Biol. 2008 Jun-Jul;97(2-3):479-96
references.pmid: 18394685
references.citation: Circulation. 2005 Jul 19;112(3):364-74
references.pmid: 15998679
references.citation: Circulation. 1995 Jun 1;91(11):2717-20
references.pmid: 7758175
references.citation: Biochem Biophys Res Commun. 1997 Oct 29;239(3):794-8
references.pmid: 9367848
references.citation: Circulation. 1995 Nov 1;92(9 Suppl):II191-5
references.pmid: 7586406
references.citation: Circulation. 2005 Aug 30;112(9 Suppl):I57-64
references.pmid: 16159866
references.citation: Circulation. 2004 May 18;109(19):2263-5
references.pmid: 15136495
references.citation: Ann N Y Acad Sci. 2007 Mar;1099:349-60
references.pmid: 17446475
references.citation: J Heart Lung Transplant. 1997 Nov;16(11):1176-9
references.pmid: 9402519
references.citation: Physiol Rev. 1999 Jan;79(1):215-62
references.pmid: 9922372
references.citation: J Heart Lung Transplant. 2001 Apr;20(4):457-64
references.pmid: 11295584
references.citation: J Heart Lung Transplant. 2009 Feb;28(2):117-22
references.pmid: 19201335
references.citation: Proc Natl Acad Sci U S A. 2000 Nov 7;97(23):12746-51
references.pmid: 11070088
references.citation: Endocrinology. 2008 Nov;149(11):5822-7
references.pmid: 18617621
references.citation: Circulation. 2001 Aug 21;104(8):881-6
references.pmid: 11514373
references.citation: J Thorac Cardiovasc Surg. 2006 May;131(5):975-80
references.pmid: 16678578
references.citation: J Am Coll Cardiol. 2005 Mar 1;45(5):668-76
references.pmid: 15734609
references.citation: Clin Cardiol. 1995 Sep;18(9 Suppl 4):IV4-12
references.pmid: 7489620
references.citation: Circulation. 1993 Jun;87(6):1854-65
references.pmid: 8504498
references.citation: Thorac Cardiovasc Surg. 1999 Feb;47(1):48-50
references.pmid: 10218621
references.citation: Am J Cardiol. 1997 Dec 4;80(11A):15L-25L
references.pmid: 9412539
references.citation: J Card Fail. 2002 Dec;8(6 Suppl):S476-85
references.pmid: 12555161
references.citation: Circulation. 1997 Jul 15;96(2):542-9
references.pmid: 9244223
references.citation: Eur Heart J. 2003 Jul;24(14):1329-39
references.pmid: 12871690
references.citation: J Mol Cell Cardiol. 1995 Jan;27(1):397-406
references.pmid: 7539084
references.citation: Circulation. 1997 May 20;95(10):2434-40
references.pmid: 9170407
references.citation: J Thorac Cardiovasc Surg. 2000 Nov;120(5):843-53
references.pmid: 11044309
references.citation: Circulation. 1998 Jun 16;97(23):2316-22
references.pmid: 9639375
references.citation: Chest. 1995 Jun;107(6):1499-503
references.pmid: 7781336
references.citation: Circulation. 2005 Aug 30;112(9 Suppl):I46-50
references.pmid: 16159864
references.citation: J Heart Lung Transplant. 2003 Feb;22(2):137-46
references.pmid: 12581761
references.citation: Cardiovasc Pathol. 2011 May-Jun;20(3):139-45
references.pmid: 20185339
references.citation: J Card Fail. 1996 Sep;2(3):243-9
references.pmid: 8891862
references.citation: Circulation. 2001 Aug 14;104(7):826-31
references.pmid: 11502710
references.citation: Eur Heart J. 2007 Mar;28(5):613-27
references.pmid: 17132651
references.citation: Circulation. 2001 Sep 4;104(10):1147-52
references.pmid: 11535571
references.citation: Circulation. 2006 Jul 4;114(1 Suppl):I16-20
references.pmid: 16820567
references.citation: Circulation. 1999 Nov 9;100(19 Suppl):II216-23
references.pmid: 10567307
references.citation: N Engl J Med. 1996 Oct 17;335(16):1182-9
references.pmid: 8815940
references.citation: J Heart Lung Transplant. 1997 Jul;16(7):765-73
references.pmid: 9257259
references.citation: Physiol Genomics. 2003 Aug 15;14(3):251-60
references.pmid: 12824457
references.citation: Cardiovasc Res. 2005 Dec 1;68(3):376-86
references.pmid: 16024006
references.citation: Cardiovasc Res. 1997 May;34(2):323-8
references.pmid: 9205546
references.citation: Circ Res. 1991 Mar;68(3):734-44
references.pmid: 1835909
references.citation: J Mol Cell Cardiol. 1995 Jun;27(6):1281-92
references.pmid: 8531210
references.citation: Cardiovasc Res. 2004 Nov 1;64(2):308-14
references.pmid: 15485690
references.citation: Biomed Biochim Acta. 1987;46(8-9):S634-9
references.pmid: 2449194
references.citation: J Am Coll Cardiol. 1989 Jun;13(7):1637-52
references.pmid: 2656824
references.citation: Lancet. 2002 Mar 16;359(9310):936-41
references.pmid: 11918913
references.citation: J Heart Lung Transplant. 2006 Jan;25(1):7-15
references.pmid: 16399524
references.citation: J Heart Lung Transplant. 2007 Mar;26(3):230-5
references.pmid: 17346624
references.citation: Rev Cardiovasc Med. 2003;4 Suppl 2:S14-20
references.pmid: 12776009
references.citation: Circulation. 1995 Jan 1;91(1):161-70
references.pmid: 7805198
references.citation: Eur Heart J. 2001 Apr;22(7):534-40
references.pmid: 11259141
references.citation: Crit Care Med. 1994 Mar;22(3):448-54
references.pmid: 8124996
references.citation: N Engl J Med. 2006 Nov 2;355(18):1873-84
references.pmid: 17079761
references.citation: Circulation. 1998 Aug 18;98(7):656-62
references.pmid: 9715858
references.citation: Curr Opin Cardiol. 1999 May;14(3):196-205
references.pmid: 10358790
references.citation: J Immunol. 1996 Jan 1;156(1):13-7
references.pmid: 8598453
references.citation: Cell Calcium. 2004 Aug;36(2):111-8
references.pmid: 15193859
references.citation: J Heart Lung Transplant. 2005 May;24(5):609-13
references.pmid: 15896760
references.citation: Circ Res. 1990 Jul;67(1):23-34
references.pmid: 2364493
references.citation: Ann Intern Med. 1994 Sep 1;121(5):363-71
references.pmid: 8042826