Regression of Cellular Hypertrophy After Left Ventricular Assist Device Support

Publisher Website
Google Scholar
Abstract
Background —Although multiple studies have shown that the left ventricular assist device (LVAD) improves distorted cardiac geometry, the pathological mechanisms of the “reverse remodeling” of the heart are unknown. Our goal was to determine the effects of LVAD support on cardiac myocyte size and shape. Methods and Results —Isolated myocytes were obtained at cardiac transplantation from 30 failing hearts (12 ischemic, 18 nonischemic) without LVAD support, 10 failing hearts that received LVAD support for 75±15 days, and 6 nonfailing hearts. Cardiac myocyte volume, length, width, and thickness were determined by use of previously validated techniques. Isolated myocytes from myopathic hearts exhibited increased volume, length, width, and length-to-thickness ratio compared with normal myocytes ( P P Conclusions —These studies suggest that the regression of cellular hypertrophy is a major contributor to the “reverse remodeling” of the heart after LVAD implantation. The favorable alterations in geometry that occur in parallel fashion at both the organ and cellular levels may contribute to reduced wall stress and improved mechanical performance after LVAD support.