Left Ventricular Remodeling and Myocardial Recovery on Mechanical Circulatory Support

Marc A. Simon, Brian A. Primack, Jeffrey Teuteberg, Robert L. Kormos, Christian Bermudez, Yoshiya Toyoda, Hemal Shah, John Gorcsan, Dennis M. McNamara

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

Background: Myocardial recovery after ventricular assist devices (VAD) is rare but appears more common in nonischemic cardiomyopathies (NICM). We sought to evaluate left ventricular (LV) end diastolic diameter (LVEDD) for predicting recovery after VAD. Methods and Results: NICM patients receiving long-term mechanical support between 1996 and 2008 were reviewed. Subjects were divided into 3 groups: mild, moderate, and severe dilation (Group A: LVEDD <6.0 cm [n = 22]; Group B: 6.0-7.0 cm [n = 32]; Group C: >7.0 cm [n = 48], respectively). Overall, recovery (successful explant without transplantation) occurred in 14 of 102 subjects (14%). Of these, 2 died and 2 required transplantation within 1 year. Recovery was more common in patients without LV dilation (Groups A/B/C = 32%/22%/0%, P < .001), as was sustained recovery (alive and transplant free 1 year after explant; A/B/C = 27%/10%/0%, P = .001). Of the recovery patients in Group A, 6/7 (86%) had sustained recovery versus 3/6 (50%) in Group B. Conclusions: Recovery occurred in 32% of NICM patients without significant LV dilation at time of VAD, the majority of whom experienced significant sustained recovery. Recovery was not evident in those with severe LV dilation. Routine echocardiography at the time of implant may assist in targeting patients for recovery after VAD.

Original languageEnglish (US)
Pages (from-to)99-105
Number of pages7
JournalJournal of Cardiac Failure
Volume16
Issue number2
DOIs
StatePublished - Feb 2010

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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