Transvalvular Mechanical Circulatory Support Reverse Remodels the Ischemic Chronic Failing Heart in an Ovine Model

Sixteen sheep with ischemic chronic heart failure were randomized to either 3 months of Impella 5.5 support (Abiomed) or sham. Myocardial reverse remodeling by Impella support was shown by a significant reduction of end-diastolic volume (Impella 22% reduction, and control 5% increase; P = 0.011) and end-systolic volume (Impella 20% reduction, and control 11% increase; P = 0.011). Functional measurements demonstrated improved regional ejection fraction and wall thickening in the viable myocardium of hearts supported with Impella. Supported animals had a significant decrease in wall volume, with less cardiomyocyte hypertrophy than control subjects.