Physiological aspects of myocardial function improving during mechanical circulatory support

Abstract

In recent years, the mechanical support of blood circulation has proved to be a vital therapy for a terminal heart failure, and is considered as a "bridge" to transplantation or is used on a permanent basis in a patient who can not be included in the waiting list for a donor organ. Recent studies of the critical heart failure treatment during an assist device in situ have shown the myocardial recovery at the molecular and cellular levels. However, the transition of these changes to a functionally stable recovery of the heart function, which would allow the long-term results to be achieved without a heart transplant or switching off the mechanical support, is now rather an exception to the rule. At this time, the cause of the discrepancy between the high rate of recovery at the cellular and molecular levels and the low rate of cardiac function recovery remains poorly understood. Patients with chronic progressive heart failure can demonstrate the normalization of many structural myocardial abnormalities after a mechanical support that is actually a reverse remodeling. However, the reverse remodeling is not always considered equivalent to clinical recovery. The aim of this research is to study a significant improvement in the structure and function of the myocardium during the mechanical support of blood circulation.