TY - JOUR
T1 - Left ventricular assist device support and myocardial recovery in recent onset cardiomyopathy
AU - Boehmer, John P.
AU - Starling, Randall C.
AU - Cooper, Leslie T.
AU - Torre-Amione, Guillermo
AU - Wittstein, Ilan
AU - Dec, G. William
AU - Markham, David W.
AU - Zucker, Mark J.
AU - Gorcsan, John
AU - McTiernan, Charles
AU - Kip, Kevin
AU - McNamara, Dennis M.
PY - 2012/10
Y1 - 2012/10
N2 - Background: Left ventricular assist device (LVAD) support as bridge to recovery (BTR) is uncommon for subjects with chronic heart failure. Myocardial recovery is more evident in recent onset nonischemic cardiomyopathy (ROCM); however, the prevalence of BTR in this subset has not been addressed. Methods and Results: We examined the use of LVAD support for subjects with ROCM in the Intervention in Myocarditis and Acute Cardiomyopathy 2 (IMAC2) study. The overall cohort (n = 373) was 38% female, 21% black, with a mean age of 45 ± 14 years. LVAD support was used in 3.8% (n = 14, 43% female, age 32 ± 10). Of LVAD subjects, 57% (8/14) were BTR, including 73% (8/11) of subjects with symptoms ≤4 months at the time of support. Left ventricular end-diastolic diameter (LVEDD) was smaller in BTR than nonrecovered (NR) subjects (P =.04). Myocardial inflammation was more common in BTR (75% versus 0%, P =.005), whereas fibrosis was less evident (25% versus 100%, P =.005). Of BTR subjects, 7/8 (87.5%) were alive and free of transplant with median follow-up of 19 months. Conclusion: In a multicenter registry of ROCM, BTR was common and occurred in the majority of subjects requiring LVAD support. Histology and LVEDD may assist in predicting potential for BTR in ROCM.
AB - Background: Left ventricular assist device (LVAD) support as bridge to recovery (BTR) is uncommon for subjects with chronic heart failure. Myocardial recovery is more evident in recent onset nonischemic cardiomyopathy (ROCM); however, the prevalence of BTR in this subset has not been addressed. Methods and Results: We examined the use of LVAD support for subjects with ROCM in the Intervention in Myocarditis and Acute Cardiomyopathy 2 (IMAC2) study. The overall cohort (n = 373) was 38% female, 21% black, with a mean age of 45 ± 14 years. LVAD support was used in 3.8% (n = 14, 43% female, age 32 ± 10). Of LVAD subjects, 57% (8/14) were BTR, including 73% (8/11) of subjects with symptoms ≤4 months at the time of support. Left ventricular end-diastolic diameter (LVEDD) was smaller in BTR than nonrecovered (NR) subjects (P =.04). Myocardial inflammation was more common in BTR (75% versus 0%, P =.005), whereas fibrosis was less evident (25% versus 100%, P =.005). Of BTR subjects, 7/8 (87.5%) were alive and free of transplant with median follow-up of 19 months. Conclusion: In a multicenter registry of ROCM, BTR was common and occurred in the majority of subjects requiring LVAD support. Histology and LVEDD may assist in predicting potential for BTR in ROCM.
KW - Mechanical circulatory support (MCS)
KW - myocarditis
KW - nonischemic cardiomyopathy
KW - outcomes
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U2 - 10.1016/j.cardfail.2012.08.001
DO - 10.1016/j.cardfail.2012.08.001
M3 - Article
C2 - 23040110
AN - SCOPUS:84867162885
SN - 1071-9164
VL - 18
SP - 755
EP - 761
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 10
ER -