Long-term mechanical ventricular assistance toward myocardial recovery

Myocardial recovery after VAD support provides a perfect example of reverse remodeling. It also establishes that heart failure may not be an end of the road situation. Although post-LVAD myocardial recovery has become a distinct entity, basis of reversal of the dedifferentiation process will need to be further explored. With this objective, several centers in the United States have formed the LVAD Working Group to: determine the incidence of myocardial recovery; obtain serial studies to determine the response of the LVAD-supported heart to stress; and study the tissue and serological changes as they relate to the recovery process. Patients enrolled in this study will receive anti-heart failure therapy and serial examinations after implantation and explanation. Stress evaluations will include dobutamine stress echocardiograms as well as bicycle exercise with right heart catheterization. A large database of prospectively collected data will likely result in a greater understanding of myocardial recovery and the LVAD weaning process.