title: Advanced Strategies for End-Stage Heart Failure: Combining Regenerative Approaches with LVAD, a New Horizon?
abstract: Despite the improved treatment of cardiovascular diseases, the population with end-stage heart failure (HF) is progressively growing. The scarcity of the gold standard therapy, heart transplantation, demands novel therapeutic approaches. For patients awaiting transplantation, ventricular-assist devices have been of great benefit on survival. To allow explantation of the assist device and obviate heart transplantation, sufficient and durable myocardial recovery is necessary. However, explant rates so far are low. Combining mechanical circulatory support with regenerative therapies such as cell (-based) therapy and biomaterials might give rise to improved long-term results. Although synergistic effects are suggested with mechanical support and stem cell therapy, evidence in both preclinical and clinical setting is lacking. This review focuses on advanced and innovative strategies for the treatment of end-stage HF and furthermore appraises clinical experience with combined strategies.
authors.affiliation: Department of Cardiology, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands ; Interuniversity Cardiology Institute of the Netherlands , Utrecht , Netherlands.
authors.forename: Cheyenne C S
authors.initials: CC
authors.lastname: Tseng
authors.affiliation: Department of Cardio-thoracic Surgery, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands.
authors.forename: Faiz Z
authors.initials: FZ
authors.lastname: Ramjankhan
authors.affiliation: Department of Cardiology, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands.
authors.forename: Nicolaas
authors.initials: N
authors.lastname: de Jonge
authors.affiliation: Department of Cardiology, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands.
authors.forename: Steven A J
authors.initials: SA
authors.lastname: Chamuleau
keywords: cardiac recovery; cell therapy; heart failure; mechanical circulatory support; regenerative therapies; ventricular-assist device