Contribution of ventricular assist devices to the recovery of failing hearts: A review and the Berlin Heart Center Experience

European Journal of Heart Failure

Volumn 16, Issue 3, 2014, Pages 248-263

  Dandel, Michael ^a,b   Knosalla, Christoph ^a,b   Hetzer, Roland ^a,b  

^a DEUTSCHES HERZZENTRUM BERLIN   (Germany)

^b DZHK GERMAN CENTRE FOR CARDIOVASCULAR RESEARCH   (Germany)

Author keywords

Heart failure; Myocardial recovery; Risk factors; Survival; Ventricular assist devices; Ventricular function

Indexed keywords

ARGATROBAN; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CARVEDILOL; CLENBUTEROL; DIGOXIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; HEPARIN; LISINOPRIL; LOSARTAN; NORADRENALIN; SPIRONOLACTONE;

APOPTOSIS; CELL SIZE; CLINICAL PROTOCOL; CONGESTIVE CARDIOMYOPATHY; ECHOCARDIOGRAPHY; EXERCISE TEST; EXTRACELLULAR MATRIX; GERMANY; HEART CATHETERIZATION; HEART FAILURE; HEART FUNCTION; HUMAN; MEDICAL DECISION MAKING; MUSCLE CELL; PRIORITY JOURNAL; RECURRENT DISEASE; REVIEW; VENTRICULAR ASSIST DEVICE; WEANING;

HEART FAILURE; MYOCARDIAL RECOVERY; RISK FACTORS; SURVIVAL; VENTRICULAR ASSIST DEVICES; VENTRICULAR FUNCTION;

ECHOCARDIOGRAPHY; HEART FAILURE; HEART-ASSIST DEVICES; HUMANS; RECOVERY OF FUNCTION;

EID: 84896965177     PISSN: 13889842     EISSN: 18790844     Source Type: Journal    
DOI: 10.1002/ejhf.18     Document Type: Review

References (71)

1. Müller J, Wallukat G, Weng Y, Dandel M, Spiegelsberger S, Semrau S, Brandes K, Bieda H, Hummel M, Loebe M, Meyer R, Hetzer R. Weaning from mechanical cardiac support in patients with dilated cardiomyopathy. Circulation 1997;96:542-549.
2. Hetzer R, Müller J, Weng Y, Wallukat G, Spiegelsberger S, Loebe M. Cardiac recovery in dilated cardiomyopathy by unloading with a left ventricular assist device. Ann Thorac Surg 1999;68:742-749.
3. Dandel M, Weng Y, Sinawski H, Potapov E, Lehmkuhl HB, Hetzer R. Long-term results in patients with idiopathic dilated cardiomyopathy after weaning from left ventricular assist devices. Circulation 2005;112:37-45.
4. Frazier OH, Benedect CR, Radovancevic B, Bick RJ, Capek P, Springer WE, Macris MP, Delgado R, Buja LM. Improved left ventricular function after chronic left ventricular unloading. Ann Thorac Surg 1996;62:675-682.
5. Hall JL, Fermin DR, Birks EJ, Barton PJ, Slaughter M, Eckman P, Baba HA, Wohlschlaeger J, Miller LW. Clinical, molecular, and genomic changes in response to a left ventricular assist device. J Am Coll Cardiol 2011;57:641-652.
6. Akhter SA, D'Souza KM, Malhotra R, Staron ML, Valeroso TB, Fedson SE, Anderson AS, Raman J, Jeevanandam V. Reversal of impaired myocardial betaadrenergic receptor signaling by continuous-flow left ventricular assist device support. J Heart Lung Transplant 2010;29:603-609.
7. Saito S, Matsumiya G, Sakaguchi T, Miyagawa S, Yamauchi T, Kuratani T, Sawa Y. Cardiac fibrosis and cellular hypertrophy decrease the degree of reverse remodeling and improvement in cardiac function during left ventricular assist. J Heart Lung Transplant 2010;29:672-679.
8. Ogletree ML, Sweet WE, Talerico C, Klecka ME, Young JB, Smedira NG, Starling RC, Moravec CS. Duration of left ventricular assist device support: effects on abnormal calcium cycling and functional recovery in the failing human heart. J Heart Lung Transplant 2010;29:554-561.
9. Maybaum S, Mancini D, Xydas S, Starling RC, Aaronson K, Pagani FD, Miller RW, Margules K, McRee S, Frazier OH, Torre-Amione G, LVAD Working Group. Cardiac improvement during mechanical circulatory support: a prospective multicenter study of the LVAD Working Group. Circulation 2007;15:2497-2505.
10. Ambardekar AV, Walker JS, Walker LA, Cleveland JC Jr, Lowes BD, Buttrick PM. Incomplete recovery of myocyte contractile function despite improvement of myocardial architecture with left ventricular assist device support. Circ Heart Fail 2011;4:425-432.
11. Ferrar DJ, Holmann WR, McBride LR, Kormos RL, Icenogle TB, Hendry PJ, Moore CH, Loisance DY, El-Banayosy A, Frazier H. Long-term follow up of Thoratec ventricular assist device bridge-to-recovery patients successfully removed from support after recovery of ventricular function. J Heart Lung Transplant 2002;21:516-521.
12. Simon MA, Kormos RL, Murali S, Nair P, Heffernan M, Gorcsan J, Winowich S, McNamara DM. Myocardial recovery using ventricular assist devices: prevalence, clinical characteristics, and outcomes. Circulation 2005;112: I-32-I-36.
13. Birks EJ, Tansley PD, Hardy J, George RS, Bowles CT, Burke M, Banner NR, Khagani A, Yacoub MH. Left ventricular assist device and drug therapy for the reversal of heart failure. N Engl J Med 2006;355:1873-1884.
14. Dandel M, Weng Y, Siniawski H, Potapov E, Drews T, Lehmkuhl HB, Knosalla C, Hetzer R. Prediction of cardiac stability after weaning from ventricular assist devices in patients with idiopathic dilated cardiomyopathy. Circulation 2008;118:S94-S105.
15. Hetzer R, Dandel M, Knosalla C. Left ventricular assist devices and drug therapy in heart failure. N Engl J Med 2007;356:869-870.
16. Dandel M, Weng Y, Siniawski H, Stepanenko A, Krabatsch T, Potapov E, Lehmkuhl HB, Knosalla C, Hetzer R. Heart failure reversal by ventricular unloading in patients with chronic cardiomyopathy: criteria for weaning from ventricular assist devices. Eur Heart J 2011;32:1148-1160.
17. Dandel M, Weng Y, Siniawski H, Potapov E, Krabatsch T, Lehmkuhl HB, Drews T, Knosalla C, Hetzer R. Pre-explant stability of unloading promoted cardiac improvement predicts outcome after weaning from ventricular assist devices. Circulation 2012;126:S3-S19.
18. Mann DL, Barger MP, Burkhoff D. Myocardial recovery and the failing heart: myth, magic, or molecular target? J Am Coll Cardiol 2012;60:2465-2472.
19. Mancini DM, Beniaminovitz A, Levin H, Catanese K, Flannery M, Di Tullio M, Savin S, Cordisco ME, Rose E, Oz M. Low incidence of myocardial recovery after left ventricular assist device implantation in patients with chronic heart failure. Circulation 1998;98:2383-2389.
20. Baba HA, Wohlschaeger J. Morphological and molecular changes in the myocardium after left ventricular mechanical support. Curr Cardiol Rev 2008;4:157-169.
21. Drakos SG, Kfoury AG, Hammond EH, Reid BB, Revelo MP, Rasmusson BY, Whitehead KJ, Salama ME, Selzman CH, Stehlik J, Clayson SE, Bristow MR, Renlund DG, Li DY. Impact of mechanical unloading on micro-vasculature and associated central remodeling features of the failing human heart. J Am Coll Cardiol 2010;56:382-391.
22. Zafeiridis A, Jeevanadam V, Houser SR, Margulies KB. Regression of cellular hypertrophy after ventricular assist device support. Circulation 1998;98:656-662.
23. Baba HA, Grabellus F, August C, Plenz G, Takeda A, Tjan TD, Schmid C, Deng MC. Reversal of metallothionein expression is different throughout the human myocardium after prolonged left-ventricular mechanical support. J Heart Lung Transplant 2000;19:668-674.
24. Terraciano CMN, Hardy J, Birks EJ, Khaghani A, Banner NR, Yacoub MH. Clinical recovery from end-stage heart failure using left ventricular assist device and pharmacological therapy correlates with increased sarcoplasmic reticulum calcium content but not with regression of cellular hypertrophy. Circulation 2004;109:2263-2265.
25. Bruggink AH, Van Oostehout MF, De Jonge N, Ivangh B, Van Kuik J, Voorbij RH, Cleutjens JP, Gmelig-Meyling FH, De Weger RA. Reverse remodeling of the myocardial extracellular matrix after prolonged left ventricular device support follows a biphasic pattern. J Heart Lung Transplant 2006;25:1091-1098.
26. Li YY, Feng Y, McTiernan CF, Pei W, Moravec CS, Wang P, Rosenblum W, Kormos RL, Feldman AM. Downregulation of matrixmetalloproteinases and reduction in collagen damage in the failing human heart after support with left ventricular assist devices. Circulation 2001;104:1147-1152.
27. Klotz S, Foronjy RF, Dickstein ML, Gu A, Garrelds IM, Danser AH, Oz MC, D'Armiento J, Burkhoff D. Mechanical unloading during left ventricular assist device support increases left ventricular collagen cross-linking and myocardial stiffness. Circulation 2005;112:364-374.
28. Wohlschlaeger J, Schmitz KJ, Schmid C, Schmid KW, Keul P, Takeda A, Weis S, Levkau B, Baba HA. Reverse remodeling following insertion of left ventricular assist devices (LVAD): a review of the morphological and molecular changes. Cardiovasc Res 2005;68:376-386.
29. Muranaka H, Marui A, Tsukashita M, Wang J, Nakano J, Ikeda T, Sakata R. Prolonged mechanical unloading preserves myocardial contractility but impairs relaxation in rat heart of dilated cardiomyopathy accompanied by myocardial stiffness and apoptosis. J Thorac Cardiovasc Surg 2010;140:916-922.
30. Latif N, Yacoub MH, George R, Barton PJ, Birks EJ. Changes in sarcomeric and non-sarcomeric cytoskeletal proteins and focal adhesion molecules during clinical myocardial recovery after left ventricular assist device support. J Heart Lung Transplant 2007;26:230-235.
31. Birks EJ, Hall JL, Barton PJR, Grindle S, Latif N, Hary JP, Rider JE, Banner NR, Khaghani A, Miller LW, Yacoub MH. Gene profiling changes in cytoskeletal proteins during clinical recovery after left ventricular-assist support. Circulation 2005;112(Suppl. I):I-57-I-64.
32. De Jonge N, Van Wichen DF, Schipper ME, Laphor JR, Gmeling-Meyling FH, Robles De Medina EO, De Weger RA. Left ventricular assist device in endstage heart failure: persistence of structural myocyte damage after unloading: an immunohistochemical analysis of the contractile myofilaments. J Am Coll Cardiol 2002;39:963-969.
33. Lee SH, Doliba N, Osbakken M, Oz M, Mancini D. Improvement of myocardial mitochondrial function after hemodynamic support with left ventricular assist devices in patients with heart failure. J Thorac Cardiovasc Surg 1998;116:344-349.
34. Klotz S, Barbone A, Reiken S, Holmes JW, Naka Y, Oz MC, Marks AR, Burkhoff D. Left ventricular assist device support normalizes left and right ventricular β-adrenergic pathway properties. J Am Coll Cardiol 2005;45:668-676.
35. Heedt PM, Holmes JW, Cai B, Barbone A, Madigan JD, Reiken S, Lee DL, Oz MC, Marks AR, Burkhoff D. Chronic ventricular unloading by ventricular assist devices reverse contractile dysfunction and alters gene expression in end-stage heart failure. Circulation 2000;102:2713-2719.
36. Rodriue-Way A, Burkoff D, Geesaman BJ, Golden S, Xu J, Pollman MJ, Donoghue M, Jeyaseelan R, Houser S, Breitbart RE, Marks A, Acton S. Sarcomeric genes involved in reverse remodeling of the heart during left ventricular assist device support. J Heart Lung Transplant 2005;24:73-80.
37. Inglese J, Freedman NJ, Koch WJ, Lefkowitz RJ. Structure and mechanism of the G protein-coupled receptor kinases. J Biol Chem 1993;268:23735-23738.
38. Ungerer M, Bohm M, Elce JS, Erdmann E, Lohse MJ. Altered expression of betaadrenergic receptor kinase and beta 1-adrenergic receptors in the failing human heart. Circulation 1993;87:454-463.
39. Pandalai PK, Bulcao CF, Merrill WH, Akhter SA. Restoration of myocardial betaadrenergic receptor signaling after left ventricular assist device support. J Thorac Cardiovasc Surg 2006;131:975-980.
40. Akhter SA, Eckhart AD, Rockman HA, Shotwell K, Lefkowitz RJ, Koch WJ. In vivo inhibition of elevated myocardial beta-adrenergic receptor kinase activity in hybrid transgenic mice restores normal beta-adrenergic signaling and function. Circulation 1999;100:648-653.
41. Hall JL, Torre-Amione G. Cellular, molecular, genomic and functional changes that occur in the failing heart in response to mechanical circulatory support. In Kormos RL, Miller LW, eds. Mechanical Circulatory Support. A Companion to Braunwald's Heart Disease. Philadelphia, PA: Elsevier; 2012. pp258-271.
42. Torre-Amione G, Kapadia S, Lee J, Durand JB, Bies RD, Young JB, Mann DL. Tumor necrosis factor-β and tumor necrosis factor receptors in the failing heart. Circulation 1996;93:704-711.
43. Blaxall BC, Tschannen-Moran BM, Milano CA, Koch WJ. Differential gene expression and genomic patient stratification following left ventricular assist device support. J Am Coll Cardiol 2003;41:1096-1106.
44. Torre-Amione G, Stetson SJ, Youker KA, Durand J-B, Radovanevic B, Delgado RM, Frazier OH, Entman ML, Noon GP. Decreased expression of tumor necrosis factor-β in failing human myocardium after mechanical circulatory support: a potential mechanism for cardiac recovery. Circulation 1999;100:1189-1193.
45. Jahns R, Boivin V, Hein L, Triebel S, Angermann CE, Ertl G, Lohse MJ. Direct evidence for a beta-1 adrenergic receptor-directed autoimmune attack as a cause of idiopathic dilated cardiomyopathy. J Clin Invest 2004;113:1419-1429.
46. Dandel M, Wallukat G, Englert A, Lehmkuhl HB, Knosalla C, Hetzer R. Long-term benefits of immunoadsorption in β (1)-adrenoceptor autoantibodypositive transplant candidates with dilated cardiomyopathy. Eur J Heart Fail 2012;14:1374-1388.
47. Francis GS, Anwar F, Bank AJ, Kubo SH, Jessurun J. Apoptosis, Bcl-2and proliferating cell nuclear antigen in the failing human heart: observation made after implantation of left ventricular assist device. J Card Fail 1999;5:308-315.
48. Manginas A, Tsiavou A, Sfyrakis P, Giamouzis G, Tsourelis L, Leontiadis E, Degiannis D, Cokkinos DV, Alivizatos PA. Increased number of circulating progenitor cells after implantation of ventricular assist devices. J Heart Lung Transplant 2009;28:710-717.
49. Wohlschlaeger J, Levkau B, Brockoff G, Schmitz KJ, Von Winterfeld M, Takeda A, Takeda N, Stypmann J, Vahlhaus C, Schmid C, Pomjanski N, Böcking A, Baba HA. Hemodynamic support by left ventricular assist devices reduces cardiomyocyte DNA content in the failing human heart. Circulation 2010;121:989-996.
50. Birks EJ, Miller LW. Myocardial recovery with use of ventricular assist devices. In Kormos RL, Miller LW, eds. Mechanical Circulatory Support. A Companion to Braunwald's Heart Disease. Philadelphia, PA: Elsevier; 2012. pp220-238.
51. Mano A, Nakatani T, Oda N, Kato T, Niwaya K, Tagusari O, Nakajima H, Funatsu T, Hashimoto S, Komamura K, Hanatani A, Ueda IH, Kitakaze M, Kobayashi J, Yagihara T, Kitamura S. Which factors predict the recovery of natural heart function after insertion of a left ventricular assist system. J Heart Lung Transplant 2008;27:869-874.
52. Birks EJ, George RS, Firouzi A, Wright G, Bahrami T, Yacoub MH, Khaghani A. Long-term outcomes of patients bridged to recovery versus patients bridged to transplantation. J Thorac Cardiovasc Surg 2012;144:190-196.
53. Kirklin JK, Naftel DC, Kormos RL, Stevensen LW, Pagani FD, Miller MM, Baldwin TJ, Joung JB. Fifth INTERMACS Annual Report: risk factor analysis for more than 6000 mechanical circulatory support patients. J Heart Lung Transplant 2013;32:141-156.
54. Merlo M, Pyxaras SA, Pinamonti B, Barbati G, Di Lenarda A, Sinagra G. Prevalence and prognostic significance of left ventricular reverse remodelling in dilated candiomyopathy receiving tailored treatment. J Am Coll Cardiol 2011;57:1468-1476.
55. Birks EJ, George RS, Hedger M, Bahrami T, Wilton P, Bowles CT, Webb C, Bougard R, Amrani M, Yacoub MH, Dreyfus G, Khaghani A. Reversal of severe heart failure with a continuous-flow left ventricular assist device and pharmacological therapy: a prospective study. Circulation 2011;123:381-390.
56. Krabatsch T, Schweiger M, Dandel M, Stepanenko A, Drews T, Potapov E, Pasic M, Weng YG, Huebler M, Hetzer R. Is bridge to recovery more likely with pulsatile left ventricular assist devices than with nonpulsatile-flow systems? Ann Thorac Surg 2011;91:1335-1340.
57. Hetzer R, Müller J, Weng Y, Meyer R, Dandel M. Bridging-to-recovery. Ann Thorac Surg 2001;71:S109-S113.
58. Hetzer R, Potapov EV, Alexi-Meskishvili V, Weng Y, Moera O, Berger F, Hennig E, Hübler M. Single-center experience with treatment of cardiogenic shock in children by pediatric assist devices. J Thorac Cardiovasc Surg 2011;141:616-623.
59. Blume ED, Naftel DC, Bastardi HJ, Duncan BW, Kirklin JK, Webber SA. Outcomes of children bridged to heart transplantation with ventricular assist devices. Circulation 2006;113:2213-2319.
60. Morales DL, Almond CS, Jaquiss RD, Rosenthal DN, Naftel DC, Massicotte MP, Humpl T, Turrentine MW, Tweddell JS, Cohen GA, Kroslowitz R, Devaney EJ, Canter CE, Fynn-Thompson F, Reinhartz O, Imamura M, Ghanayem NS, Buchholz H, Furness S, Mazor R, Gandhi SK, Fraser CD Jr. Bridging children of all sizes to cardiac transplantation: the initial multi-center North American experience with the Berlin Heart EXCOR ventricular assist device. J Heart Lung Transplant 2011;30:1-8.
61. Almond CS, Morales DL, Blackstone EH, Turrentine MW, Imamura M, Massicotte MP, Jordan LC, Devaney EJ, Ravishankar C, Kanter KR, Holman W, Kroslowitz R, Tjossem C, Thuita L, Cohen GA, Buchholz H, St Louis JD, Nguyen K, Niebler RA, Walters HL III, Reemtsen B, Wearden PD, Reinhartz O, Guleserian KJ, Mitchell MB, Bleiweis MS, Canter CE, Humpl T. Berlin Heart EXCOR pediatric ventricular assist device for bridge to heart transplantation in US children. Circulation 2013;127:1702-1711.
62. Taylor DO, Edwards LB, Boucek MM, Trulock EP, Aurora P, Christie J, Dobbels F, Rahmel AO, Keck BM, Hertz I. The registry of the international society for heart and lung transplantation: twenty fourth official adult transplant report-2007. J Heart Lung Transplant 2007;26:769-781.
63. George RS, Yacoub MH, Tasca G, Webb C, Bowles CT, Tansley P, Hardy JP, Dreyfus G, Khaghani A, Birks EJ. Heamodynamic and echocardiographic responses to acute interruption of left ventricular assist device support-relevance to assessment of myocardial recovery. J Heart Lung Transplant 2007;26:967-973.
64. Khan T, Okerberg K, Hernandez A, Miller K, Myers TJ, Radovancevic B, Delgado RM, Gregoric I, Frazier OH. Assessment of myocardial recovery using Dobutamin stress echo-cardiography in LVAD patients. J Heart Lung Transplant 2001;20:202-203.
65. Klotz S, Burkhoff D, Garrelds IM, Boomsma F, Danser AH. The impact of left ventricular assist device induces left ventricular unloading on the myocardial renin-angiotensin-aldosterone system: therapeutic consequences? Eur Heart J 2009;30:805-812.
66. Klotz S, Danser AH, Foroniy RF, Oz MC, Wang J, Mancini D, D'Armiento J, Burkhoff D. The impact of angiotensin-converting enzyme inhibitor therapy on the extracellular collagen matrix during left ventricular assist device support in patients with end-stage heart failure. J Am Coll Cardiol 2007;49:1166-1174.
67. Moscato F, Arabia M, Colacino FM, Naiyanetr P, Danieli GA, Schima H. Left ventricular afterload impedance control by an axial flow ventricular assist device: a potential tool for ventricular recovery. Artif Organs 2010;34:736-744.
68. Dandel M, Hetzer R. Echocardiographic strain and strain rate imaging-clinical applications. Int J Cardiol 2009;132:11-24.
69. Dandel M, Lehmkuhl H, Stepanenko A, Krabatsch T, Potapov E, Weng Y, Knosalla C, Hetzer R. Evaluation of left ventricular function by tissue Doppler and 2D strain imaging can facilitate the decision to wean patients with unloading induced cardiac recovery from mechanical assist devices. Eur Heart J 2010;31 (Abstract-Suppl):67.
70. Dandel M, Potapov E, Vierecke J, Stepanenko A, Krabatsch T, Knosalla C, Hetzer R. Low diastolic arterial pressure during pre-explant off-pump trials can induce misleading overestimation of left ventricular function after left ventricular assist device removal. Circulation 2012;126:A9754.
71. Simon MA, Primack BA, Teutenberg J, Kormos RL, Bermudez C, Toyoda Y, Shah H, Gorcsan J 3rd, McNamara DM. Left ventricular remodelling and myocardial recovery on mechanical circulatory support. J Card Fail 2010;16:99-105.