Left ventricular assist device support and myocardial recovery in recent onset cardiomyopathy

John P. Boehmer, Randall C. Starling, Leslie T. Cooper, Guillermo Torre-Amione, Ilan Wittstein, G. William Dec, David W. Markham, Mark J. Zucker, John Gorcsan, Charles McTiernan, Kevin Kip, Dennis M. McNamara

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)755-761
Number of pages7
JournalJournal of Cardiac Failure
Volume18
Issue number10
DOIs
StatePublished - Oct 2012

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Heart-Assist Devices
Cardiomyopathies
Myocarditis
Registries
Histology
Fibrosis
Heart Failure
Inflammation
Transplants

Keywords

  • Mechanical circulatory support (MCS)
  • myocarditis
  • nonischemic cardiomyopathy
  • outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Boehmer, J. P., Starling, R. C., Cooper, L. T., Torre-Amione, G., Wittstein, I., Dec, G. W., ... McNamara, D. M. (2012). Left ventricular assist device support and myocardial recovery in recent onset cardiomyopathy. Journal of Cardiac Failure, 18(10), 755-761. https://doi.org/10.1016/j.cardfail.2012.08.001

Left ventricular assist device support and myocardial recovery in recent onset cardiomyopathy. / Boehmer, John P.; Starling, Randall C.; Cooper, Leslie T.; Torre-Amione, Guillermo; Wittstein, Ilan; Dec, G. William; Markham, David W.; Zucker, Mark J.; Gorcsan, John; McTiernan, Charles; Kip, Kevin; McNamara, Dennis M.

In: Journal of Cardiac Failure, Vol. 18, No. 10, 10.2012, p. 755-761.

Research output: Contribution to journalArticle

Boehmer, JP, Starling, RC, Cooper, LT, Torre-Amione, G, Wittstein, I, Dec, GW, Markham, DW, Zucker, MJ, Gorcsan, J, McTiernan, C, Kip, K & McNamara, DM 2012, 'Left ventricular assist device support and myocardial recovery in recent onset cardiomyopathy', Journal of Cardiac Failure, vol. 18, no. 10, pp. 755-761. https://doi.org/10.1016/j.cardfail.2012.08.001
Boehmer, John P. ; Starling, Randall C. ; Cooper, Leslie T. ; Torre-Amione, Guillermo ; Wittstein, Ilan ; Dec, G. William ; Markham, David W. ; Zucker, Mark J. ; Gorcsan, John ; McTiernan, Charles ; Kip, Kevin ; McNamara, Dennis M. / Left ventricular assist device support and myocardial recovery in recent onset cardiomyopathy. In: Journal of Cardiac Failure. 2012 ; Vol. 18, No. 10. pp. 755-761.
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abstract = "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.",
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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.

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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.

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