Implantable heart pumps can improve heart function in some end-stage heart failure patients awaiting transplant, and enable them to be discharged from the hospital without undergoing a transplant of a new heart, a new study suggests.
In end-stage heart failure, the heart weakens, grows larger, and shows other signs of deterioration. Implantable left ventricular assist devices (LVADs) pump blood through the body and al-low the heart's main pumping chamber to rest.
This multicenter study included 67 end-stage heart failure patients who had four different types of LVADs. The patients were evaluated every 30 days for several months after they received their LVADs.
Nine percent of the patients had their LVADs removed without needing a heart transplant, but another 9% died before the end of the data collection period.
“There are two contrasting. important findings in our study: lead researcher Dr. Simon Maybaum, medical director of the Center for Advanced Cardiac Therapy at the Albert Einstein College of Medicine's Montefiore Medical Center stated. `One, the ability to remove an LVAD from a patient with end-stage heart fail-ure was low Two, there was a high degree of improvement in heart function during the use of the assist device.”
The study also found that after 30 days with an LVAD, about one-third of the patients had a left ventricular ejection fraction (percentage of blood pumped out of the left ventricle with one beat) greater than 40%, measured when the pump flow was decreased. Healthy hearts typically have an ejection fraction of 55% to 60%.
However, the percentage of patients with a 40% ejection fraction decreased as the study progressed. There were 27% at 60 days; 19% at 90 days; and 6% at 120 days.
The researchers also measured the patients' exercise capacity after LVAD implantation and found that between 30 days and 120 days. The patients showed improvements in peak oxygen consumption and exercise endurance.
Useful For Future Research
We now have a much more reliable description of the natural history of the changes in heart function during LVAD support. That makes us optimistic that other strategies (such as drug or stem cell therapy) may allow us to further improve cardiac function: Maybaum said.
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