Myocardial Alterations in Adrenoreceptors After Ventricular Unloading with a Pulsatile vs a Nonpulsatile Device~!2010-02-15~!2010-05-06~!2010-06-10~!

We have recently shown that ventricular unloading with an implantable left ventricular assist device (LVAD) leads to improved calcium handling and membrane integrity and redistribution of alpha adrenoreceptors (AARs) and beta- adrenoreceptors (BARs). Here, we used fluorescence deconvolution microscopy to examine the effect of LVAD type (pulsatile vs non-pulsatile) on upregulation and redistribution of adrenoreceptors in core biopsy samples of the myocardium before and after the removal LVAD. We noted no major differences between the pulsatile and non-pulsatile groups; however, an individual patient's 'recovery' in adrenoreceptor numbers depended on the pre-LVAD number of receptors. These findings suggest that ventricular unloading is beneficial regardless of LVAD type; however, the degree of repair and recovery may correlate with the patient's level of ventricular dysfunction at implant and the pre-LVAD number of adrenoreceptors (130).