Improvement in 2-year survival for ventricular assist device patients after implementation of an intensive surveillance protocol

Pamboukian, Salpy V.; Tallaj, José; Brown, Robert N.; Holman, William L.; Blood, Margaret S.; George, James F.; Costanzo, María Rosa; Cadeiras, Martín; Smallfield, Melissa C.; McGiffin, David C.; Kirklin, James K.

doi:10.1016/j.healun.2011.03.001

Cited by 16 publications

(20 citation statements)

References 11 publications

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“…Consequently the Heartmate ® II was approved for BTT and destination therapy (DT) in the US 1 . Recent reports 2, 3 have demonstrated a two-year survival rate of 87% in DT patients under intense surveillance, comparable to open heart transplantation (OHT) survival statistics. In parallel, these promising outcomes of LVADs in HF therapy have spawned the translational research field of left ventricular (LV) “reverse remodeling”, which has already shown great promise for elucidating underlying molecular and cellular mechanisms.…”

Section: History Of Mechanical Circulatory Support Devicesmentioning

confidence: 79%

Molecular- and Organelle-Based Predictive Paradigm Underlying Recovery by Left Ventricular Assist Device Support

Liem

Nsair

Setty

et al. 2014

Circ: Heart Failure

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Section: History Of Mechanical Circulatory Support Devicesmentioning

confidence: 79%

Molecular- and Organelle-Based Predictive Paradigm Underlying Recovery by Left Ventricular Assist Device Support

Liem

Nsair

Setty

et al. 2014

Circ: Heart Failure

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“…Furthermore, long-term circulatory support “destination therapy” has become an increasingly realistic alternative to cardiac transplantation for most of the heart failure patients who are ineligible for transplantation because of associated co-morbidity (Pamboukian et al, 2011). Because the mechanical unloading by LVADs can decrease oxygen consumption and reduce excess load of the left ventricle in heart failure (Baughman & Jarcho, 2007; Blume et al, 2006; Klotz et al, 2008), the use of LVADs improves survival (Kugler et al, 2011; Radovancevic et al, 2007) and cardiac function (Kukucka et al, 2011) for some of the patients who were thought to have irreversible heart failure.…”

Section: Left Ventricular Assist Devices (Lvads) In the Regressionmentioning

confidence: 99%

Regression of pathological cardiac hypertrophy: Signaling pathways and therapeutic targets

Hou

Kang

2012

Pharmacology & Therapeutics

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Pathological cardiac hypertrophy is a key risk factor for heart failure. It is associated with increased interstitial fibrosis, cell death and cardiac dysfunction. The progression of pathological cardiac hypertrophy has long been considered as irreversible. However, recent clinical observations and experimental studies have produced evidence showing the reversal of pathological cardiac hypertrophy. Left ventricle assist devices used in heart failure patients for bridging to transplantation not only improve peripheral circulation but also often cause reverse remodeling of the geometry and recovery of the function of the heart. Dietary supplementation with physiologically relevant levels of copper can reverse pathological cardiac hypertrophy in mice. Angiogenesis is essential and vascular endothelial growth factor (VEGF) is a constitutive factor for the regression. The action of VEGF is mediated by VEGF receptor-1, whose activation is linked to cyclic GMP-dependent protein kinase-1 (PKG-1) signaling pathways, and inhibition of cyclic GMP degradation leads to regression of pathological cardiac hypertrophy. Most of these pathways are regulated by hypoxia-inducible factor. Potential therapeutic targets for promoting the regression include: promotion of angiogenesis, selective enhancement of VEGF receptor-1 signaling pathways, stimulation of PKG-1 pathways, and sustention of hypoxia-inducible factor transcriptional activity. More exciting insights into the regression of pathological cardiac hypertrophy are emerging. The time of translating the concept of regression of pathological cardiac hypertrophy to clinical practice is coming.

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“…A question that remains, however, is whether or not lower-volume community centers should be performing implantation of LVADs as a destination therapy [19]. Regardless, it is obvious that patients instrumented with an LVAD as destination need intensive follow-up with a multidisciplinary team approach to optimize their medical therapy, reduce the risk of device-related morbidity and improve survival [20][21][22]. Moreover, a point of concern with continuous-flow devices -especially as destination therapy grows -has been the long-term effects of non-pulsatile flow on end-organ function.…”

Section: Destination Therapymentioning

confidence: 99%

Left ventricular assist devices in heart failure

Kilic

Ailawadi

2012

Expert Review of Cardiovascular Therapy

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End-stage heart failure is an ever-growing and devastating disease. The median survival for patients with heart failure on ionotropic support alone is a meager 6 months. Historically, the only option for these patients was to be listed for heart transplantation. Out of medical necessity, the idea of left ventricular assist device (LVAD) as a bridge to transplantation was born. Since their approval by the US FDA, LVADs have quadrupled the survival in patients with heart failure. The increase in survival has also been accompanied by decreased perioperative morbidity, better biocompatibility and longer device life over first-generation LVADs. Undoubtedly, LVADs have changed the landscape of heart failure treatment and will continue to do so in the foreseeable future. In this review, we will highlight the landmark studies that have established LVADs as a therapeutic option for heart failure, as well as reviewing the current LVADs available and speculating on the advancements that will be made in the upcoming years.

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Improvement in 2-year survival for ventricular assist device patients after implementation of an intensive surveillance protocol

Cited by 16 publications

References 11 publications

Molecular- and Organelle-Based Predictive Paradigm Underlying Recovery by Left Ventricular Assist Device Support

Molecular- and Organelle-Based Predictive Paradigm Underlying Recovery by Left Ventricular Assist Device Support

Regression of pathological cardiac hypertrophy: Signaling pathways and therapeutic targets

Left ventricular assist devices in heart failure

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