Author + information
- Received February 16, 2018
- Revision received May 10, 2018
- Accepted May 11, 2018
- Published online July 23, 2018.
- Nir Uriel, MD, MSca,∗∗ (, )@NirUrielMD@UChicago@TuftsMedicalCtr@ColumbiaMed,
- Gabriel Sayer, MDa,∗,
- Shiva Annamalai, MDb,
- Navin K. Kapur, MDb and
- Daniel Burkhoff, MD, PhDc
- aSection of Cardiology, University of Chicago, Chicago, Illinois
- bThe Cardiovascular Center, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts
- cColumbia University Medical Center, and Cardiovascular Research Foundation, New York, New York
- ↵∗Address for correspondence:
Dr. Nir Uriel, Section of Cardiology, University of Chicago, 5841 South Maryland Avenue, Chicago, Illinois 60637.
Myocardial injury induces significant changes in ventricular structure and function at both the cellular and anatomic level, leading to ventricular remodeling and subsequent heart failure. Unloading left ventricular pressure has been studied in both the short-term and long-term settings, as a means of preventing or reversing cardiac remodeling. In acute myocardial infarction, cardiac unloading is used to reduce oxygen demand and limit infarct size. Research has demonstrated the benefits of short-term unloading with mechanical circulatory support devices before reperfusion in the context of acute myocardial infarction with cardiogenic shock, and a confirmatory trial is ongoing. In chronic heart failure, ventricular unloading using mechanical circulatory support can reverse many of the cellular and anatomic changes that accompany ventricular remodeling. Ongoing research is evaluating the ability of left ventricular assist devices to promote myocardial recovery and remission from clinical heart failure.
↵∗ Drs. Uriel and Sayer contributed equally to this work and are joint first authors.
Dr. Uriel has received grant support from and has been a consultant to Medtronic and Abbott. Dr. Sayer has been a consultant to Medtronic. Dr. Kapur has received institutional research grants from Abiomed, Boston Scientific, and Abbott; and has been a consultant to Abiomed, Boston Scientific, Abbott, Maquet, and Medtronic. Dr. Burkhoff has received an unrestricted educational grant from Abiomed. Dr. Annamalai has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received February 16, 2018.
- Revision received May 10, 2018.
- Accepted May 11, 2018.
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