Mechanical Unloading in Heart Failure

Myocardial injury induces significant changes in ventricular structure and function at both the cellular and anatomic level, leading to ventricular remodeling and subsequent heart failure. Unloading left ventricular pressure has been studied in both the short-term and long-term settings, as a means...

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Published in:Journal of the American College of Cardiology Vol. 72; no. 5; p. 569
Main Authors: Uriel, Nir, Sayer, Gabriel, Annamalai, Shiva, Kapur, Navin K, Burkhoff, Daniel
Format: Journal Article
Language:English
Published: United States 31.07.2018
Subjects:
Heart Failure - diagnosis
Heart Failure - physiopathology
Heart Failure - therapy
Hemodynamics - physiology
Humans
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Ventricular Function, Left - physiology
Ventricular Remodeling - physiology
mechanical circulatory support
remodeling
LVAD
acute myocardial infarction
hemodynamics
ISSN:1558-3597, 1558-3597
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Abstract Myocardial injury induces significant changes in ventricular structure and function at both the cellular and anatomic level, leading to ventricular remodeling and subsequent heart failure. Unloading left ventricular pressure has been studied in both the short-term and long-term settings, as a means of preventing or reversing cardiac remodeling. In acute myocardial infarction, cardiac unloading is used to reduce oxygen demand and limit infarct size. Research has demonstrated the benefits of short-term unloading with mechanical circulatory support devices before reperfusion in the context of acute myocardial infarction with cardiogenic shock, and a confirmatory trial is ongoing. In chronic heart failure, ventricular unloading using mechanical circulatory support can reverse many of the cellular and anatomic changes that accompany ventricular remodeling. Ongoing research is evaluating the ability of left ventricular assist devices to promote myocardial recovery and remission from clinical heart failure.
AbstractList Myocardial injury induces significant changes in ventricular structure and function at both the cellular and anatomic level, leading to ventricular remodeling and subsequent heart failure. Unloading left ventricular pressure has been studied in both the short-term and long-term settings, as a means of preventing or reversing cardiac remodeling. In acute myocardial infarction, cardiac unloading is used to reduce oxygen demand and limit infarct size. Research has demonstrated the benefits of short-term unloading with mechanical circulatory support devices before reperfusion in the context of acute myocardial infarction with cardiogenic shock, and a confirmatory trial is ongoing. In chronic heart failure, ventricular unloading using mechanical circulatory support can reverse many of the cellular and anatomic changes that accompany ventricular remodeling. Ongoing research is evaluating the ability of left ventricular assist devices to promote myocardial recovery and remission from clinical heart failure.Myocardial injury induces significant changes in ventricular structure and function at both the cellular and anatomic level, leading to ventricular remodeling and subsequent heart failure. Unloading left ventricular pressure has been studied in both the short-term and long-term settings, as a means of preventing or reversing cardiac remodeling. In acute myocardial infarction, cardiac unloading is used to reduce oxygen demand and limit infarct size. Research has demonstrated the benefits of short-term unloading with mechanical circulatory support devices before reperfusion in the context of acute myocardial infarction with cardiogenic shock, and a confirmatory trial is ongoing. In chronic heart failure, ventricular unloading using mechanical circulatory support can reverse many of the cellular and anatomic changes that accompany ventricular remodeling. Ongoing research is evaluating the ability of left ventricular assist devices to promote myocardial recovery and remission from clinical heart failure.
Myocardial injury induces significant changes in ventricular structure and function at both the cellular and anatomic level, leading to ventricular remodeling and subsequent heart failure. Unloading left ventricular pressure has been studied in both the short-term and long-term settings, as a means of preventing or reversing cardiac remodeling. In acute myocardial infarction, cardiac unloading is used to reduce oxygen demand and limit infarct size. Research has demonstrated the benefits of short-term unloading with mechanical circulatory support devices before reperfusion in the context of acute myocardial infarction with cardiogenic shock, and a confirmatory trial is ongoing. In chronic heart failure, ventricular unloading using mechanical circulatory support can reverse many of the cellular and anatomic changes that accompany ventricular remodeling. Ongoing research is evaluating the ability of left ventricular assist devices to promote myocardial recovery and remission from clinical heart failure.
Author Annamalai, Shiva
Uriel, Nir
Burkhoff, Daniel
Sayer, Gabriel
Kapur, Navin K
Author_xml – sequence: 1
  givenname: Nir
  surname: Uriel
  fullname: Uriel, Nir
  email: nuriel@medicine.bsd.uchicago.edu
  organization: Section of Cardiology, University of Chicago, Chicago, Illinois. Electronic address: nuriel@medicine.bsd.uchicago.edu
– sequence: 2
  givenname: Gabriel
  surname: Sayer
  fullname: Sayer, Gabriel
  organization: Section of Cardiology, University of Chicago, Chicago, Illinois
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  givenname: Shiva
  surname: Annamalai
  fullname: Annamalai, Shiva
  organization: The Cardiovascular Center, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts
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  givenname: Navin K
  surname: Kapur
  fullname: Kapur, Navin K
  organization: The Cardiovascular Center, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts
– sequence: 5
  givenname: Daniel
  surname: Burkhoff
  fullname: Burkhoff, Daniel
  organization: Columbia University Medical Center, and Cardiovascular Research Foundation, New York, New York
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30056830$$D View this record in MEDLINE/PubMed
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remodeling
LVAD
acute myocardial infarction
hemodynamics
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Snippet Myocardial injury induces significant changes in ventricular structure and function at both the cellular and anatomic level, leading to ventricular remodeling...
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SubjectTerms Heart Failure - diagnosis
Heart Failure - physiopathology
Heart Failure - therapy
Hemodynamics - physiology
Humans
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Ventricular Function, Left - physiology
Ventricular Remodeling - physiology
Title Mechanical Unloading in Heart Failure
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