Transcriptional patterns of reverse remodeling with left ventricular assist devices: a consistent signature.
Left ventricular assist device (LVAD) therapy has revolutionized the treatment of patients with advanced heart failure. Although originally intended for bridge-to-transplantation and destination therapy indications, a small subset of patients supported with LVADs exhibit complete myocardial recovery leading to device explanation. However, genetic and molecular determinants of partial and/or complete myocardial recovery remain largely unknown. Areas covered: We summarize current knowledge on alterations in heart failure transcriptome in response to LVAD support, as well as discuss common gene signatures potentially responsible for the reverse remodeling phenotype in the failing human heart. Expert commentary: Reverse remodeling after LVAD is likely a continuum between fully and partially recovered myocardium. Multicenter cardiac tissue repositories linked with detailed phenotype information may facilitate identification of genetic signals responsible for myocardial recovery in LVAD supported patients in the foreseeable future.
a Division of Cardiology, Department of Medicine , Columbia University Medical Center , New York , NY , USA.|b Division of Cardiovascular Medicine, Department of Medicine , University of Maryland School of Medicine , Baltimore , MD , USA.
Van-Khue
VK
Ton
c Department of Biomedical Engineering , Columbia University , New York , NY , USA.
Gordana
G
Vunjak-Novakovic
a Division of Cardiology, Department of Medicine , Columbia University Medical Center , New York , NY , USA.
Veli K
VK
Topkara
D020869:Gene Expression Profiling; D006353:Heart-Assist Devices; D006801:Humans; D007249:Inflammation / Q000235:genetics / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D014158:Transcription, Genetic; D020257:Ventricular Remodeling / Q000235:genetics*
Left ventricular assist device; gene expression; myocardial recovery; reverse remodeling; transcriptional regulation