Left ventricular assist device-induced molecular changes in the failing myocardium
| Autor: | Paul J.R. Barton, Magdi H. Yacoub, Gopal K. Soppa, Cesare M. Terracciano |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Heart Failure
medicine.medical_specialty Ventricular Remodeling business.industry medicine.medical_treatment medicine.disease Pathogenesis Cytokine Internal medicine Heart failure Ventricular assist device medicine Cardiology Animals Humans Myocyte Myocytes Cardiac Heart-Assist Devices Signal transduction Cardiology and Cardiovascular Medicine Ventricular remodeling business Signal Transduction Destination therapy |
| Zdroj: | Current Opinion in Cardiology. 23:206-218 |
| ISSN: | 0268-4705 |
| DOI: | 10.1097/hco.0b013e3282fc7010 |
| Popis: | Purpose of review There is considerable increase in the use of left ventricular assist devices for the treatment of severe heart failure. Traditionally viewed as a bridge to transplantation and more recently as a destination therapy, left ventricular assist device support is now recognized to offer potential for myocardial recovery through reverse remodeling, a potential that is further enhanced by combination with pharmacologic therapy. In this study, we examine the molecular changes associated with left ventricular assist device support and how these may contribute to the recovery process. Recent findings Studies in both patients and experimental models have demonstrated that improved function is associated with alterations in several key pathways including cell survival, cytokine signaling, calcium handling, adrenergic receptor signaling, cytoskeletal and contractile proteins, energy metabolism, extracellular matrix, and endothelial and microvascular functions. Moreover, the unique research opportunities offered by left ventricular assist device analysis are beginning to distinguish changes associated with recovery from those of mechanical unloading alone and identify potential predictors and novel therapeutic targets capable of enhancing myocardial repair. Summary Significant progress has been made toward revealing molecular changes associated with myocardial recovery from heart failure. These studies also offer new insight into the pathogenesis of heart failure and point to novel therapeutic strategies. |
| Databáze: | OpenAIRE |
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