Comprehensive Analysis of Myocardial Reverse Remodeling Following HeartWare Ventricular Assist Device Implantation

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-07-28 DOI:10.1111/ctr.70245

Yujiro Kawai, John A. Farag, Masataka Nishiga, Yu Liu, Koji Kawago, Tiffany K. Koyano, Robyn Fong, Mary Sheridan Bilbao, William Hiesinger, Hye Sook Shin, Eric M. Pfrender, Alex Dalal, Albert J. Pedroza, Jack H. Boyd, Y. Joseph Woo, Yasuhiro Shudo

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Abstract

As the prevalence of heart failure continues to rise, left ventricular assist devices (LVADs) have become an increasingly common treatment option for patients, demonstrating significant improvements in patient survival. LVAD therapy is also known to induce reverse remodeling, and its underlying mechanisms have garnered attention. This study examines the experience of end-stage heart failure patients who underwent HeartWare LVAD (HVAD, Medtronic Inc, Minneapolis, MN, USA) implantation. The patients were categorized into responder and non-responder groups to investigate the impact of LVAD therapy on hemodynamics, ventricular geometry, and transcriptomics in the heart before and after HVAD therapy. In the responder group, significant reductions in left ventricular size and improvements in left ventricular ejection fraction were observed. Furthermore, subtle enhancements in calcium cycling and unique gene expression changes were observed, which were notably different from the patterns observed in the non-responder group.

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心脏辅助装置植入后心肌逆转重构的综合分析

随着心力衰竭的患病率持续上升，左心室辅助装置（lvad）已成为患者越来越普遍的治疗选择，显示出患者生存率的显着提高。LVAD治疗也可以诱导逆向重塑，其潜在机制已经引起了人们的关注。本研究探讨了接受HeartWare LVAD （HVAD, Medtronic Inc, Minneapolis， MN， USA）植入的终末期心力衰竭患者的经验。将患者分为有反应组和无反应组，以研究LVAD治疗前后对心脏血流动力学、心室几何形状和转录组学的影响。在反应组中，观察到左心室大小显著减小，左心室射血分数显著改善。此外，观察到钙循环的微妙增强和独特的基因表达变化，这与无反应组观察到的模式明显不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.