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Left Ventricular Remodeling and Myocardial Recovery on Mechanical Circulatory Support

Simon, MA and Primack, BA and Teuteberg, J and Kormos, RL and Bermudez, C and Toyoda, Y and Shah, H and Gorcsan, J and McNamara, DM (2010) Left Ventricular Remodeling and Myocardial Recovery on Mechanical Circulatory Support. Journal of Cardiac Failure, 16 (2). 99 - 105. ISSN 1071-9164

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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. © 2010 Elsevier Inc. All rights reserved.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Simon, MAsimonma@pitt.eduSIMONMA
Primack, BAbprimack@pitt.eduBPRIMACK
Teuteberg, Jjjt19@pitt.eduJJT19
Kormos, RLkormos@pitt.eduKORMOS
Bermudez, C
Toyoda, Y
Shah, H
Gorcsan, Jgorcsan@pitt.eduGORCSAN
McNamara, DMdmm23@pitt.eduDMM23
Centers: Other Centers, Institutes, or Units > Center for Research on Media, Technology, and Health
Date: 1 February 2010
Date Type: Publication
Journal or Publication Title: Journal of Cardiac Failure
Volume: 16
Number: 2
Page Range: 99 - 105
DOI or Unique Handle: 10.1016/j.cardfail.2009.10.018
Schools and Programs: School of Medicine > Cardiothoracic Surgery
School of Medicine > Medicine
School of Medicine > Pediatrics
Refereed: Yes
ISSN: 1071-9164
MeSH Headings: Adult; Cardiomyopathies--pathology; Cardiomyopathies--physiopathology; Cardiomyopathies--surgery; Cohort Studies; Female; Heart-Assist Devices; Humans; Male; Middle Aged; Myocardium--pathology; Prospective Studies; Recovery of Function--physiology; Ventricular Dysfunction, Left--pathology; Ventricular Dysfunction, Left--physiopathology; Ventricular Dysfunction, Left--surgery; Ventricular Remodeling--physiology
Other ID: NLM NIHMS152938, NLM PMC2819986
PubMed Central ID: PMC2819986
PubMed ID: 20142020
Date Deposited: 28 Jul 2014 17:47
Last Modified: 03 Feb 2019 04:55
URI: http://d-scholarship.pitt.edu/id/eprint/22374

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