title: Continuous internal counterpulsation as a bridge to recovery in acute and chronic heart failure.
abstract: Cardiac recovery from cardiogenic shock (CS) and end-stage chronic heart failure (HF) remains an often insurmountable therapeutic challenge. The counterpulsation technique exerts numerous beneficial effects on systemic hemodynamics and left ventricular mechanoenergetics, rendering it attractive for promoting myocardial recovery in both acute and chronic HF. Although a recent clinical trial has questioned the clinical effectiveness of short-term hemodynamic support with intra-aortic balloon pump (IABP, the main representative of the counterpulsation technique) in CS complicating myocardial infarction, the issue remains open to further investigation. Moreover, preliminary data suggest that long-term IABP support in patients with end-stage HF is safe and may mediate recovery of left- or/and right-sided cardiac function, facilitating long-term weaning from mechanical support or enabling the application of other permanent, life-saving solutions. The potential of long-term counterpulsation could possibly be enhanced by implementation of novel, fully implantable counterpulsation devices.
authors.affiliation: Christos D Kontogiannis, Konstantinos Malliaras, Chris J Kapelios, John N Nanas, 3 Department of Cardiology, University of Athens School of Medicine, 11527 Athens, Greece.
authors.forename: Christos D
authors.initials: CD
authors.lastname: Kontogiannis
authors.affiliation: Christos D Kontogiannis, Konstantinos Malliaras, Chris J Kapelios, John N Nanas, 3 Department of Cardiology, University of Athens School of Medicine, 11527 Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Malliaras
authors.affiliation: Christos D Kontogiannis, Konstantinos Malliaras, Chris J Kapelios, John N Nanas, 3 Department of Cardiology, University of Athens School of Medicine, 11527 Athens, Greece.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Kapelios
authors.affiliation: Christos D Kontogiannis, Konstantinos Malliaras, Chris J Kapelios, John N Nanas, 3 Department of Cardiology, University of Athens School of Medicine, 11527 Athens, Greece.
authors.forename: Jay W
authors.initials: JW
authors.lastname: Mason
authors.affiliation: Christos D Kontogiannis, Konstantinos Malliaras, Chris J Kapelios, John N Nanas, 3 Department of Cardiology, University of Athens School of Medicine, 11527 Athens, Greece.
authors.forename: John N
authors.initials: JN
authors.lastname: Nanas
keywords: Cardiac remodeling; Counterpulsation; Heart failure; Intra-aortic balloon pump; Recovery; Reverse remodeling