[Congestive heart failure: reverse cardiac remodeling mediated by left ventricular assist devices]

Pathologe. 2012 May;33(3):175-82. doi: 10.1007/s00292-011-1559-3.
[Article in German]

Abstract

Left ventricular assist devices (LVAD) are currently used to treat patients with terminal congestive heart failure as a bridge to transplantation or as destination therapy in individuals with contraindications for cardiac transplantation. The LVADs are pulsatile or non-pulsatile systems that transport blood from the left ventricle to the ascending aorta parallel to the circulation thus providing a profound volume and pressure reduction in the left ventricle. The use of LVADs is associated with a considerable decrease of cardiac hypertrophy and dilation with significantly improved cardiac performance in a small subset of patients. The underlying process is termed reverse cardiac remodelling and is characterized by a significant decrease in the size of cardiomyocytes and reversible regulation of numerous molecular systems in the myocardium.

Publication types

  • English Abstract

MeSH terms

  • Blood Pressure / physiology
  • Blood Volume / physiology
  • Cell Size
  • DNA Replication / physiology
  • Extracellular Matrix / physiology
  • Heart Failure / pathology*
  • Heart Failure / therapy*
  • Heart-Assist Devices*
  • Humans
  • Inflammation Mediators / physiology
  • Myocardium / pathology*
  • Myocytes, Cardiac / pathology
  • Natriuretic Peptides / physiology
  • Proteasome Endopeptidase Complex / physiology
  • Receptors, Adrenergic, beta / physiology
  • Regeneration / physiology*
  • Renin-Angiotensin System / physiology
  • Signal Transduction / physiology
  • Stem Cells / pathology
  • Ubiquitin / physiology

Substances

  • Inflammation Mediators
  • Natriuretic Peptides
  • Receptors, Adrenergic, beta
  • Ubiquitin
  • Proteasome Endopeptidase Complex