Heart failure could be reversed with a new treatment that combines medication with the temporary use of an artificial heart pump, researchers at the University of Utah Health said.
Left ventricular device (LVAD) implant therapy could, according to a Utah Health press release: help reverse structural damage to the heart, eliminate the need for heart transplants, and extend the lives of some patients Center (U of U health).
“Heart transplants and LVADs have been the therapeutic cornerstones of advanced heart failure for decades,” said Dr. med. Stavros Drakos, co-author of the most recent study and head of cardiovascular research for the Department of Cardiology at the health center. “This alternative approach is different, however. It appears to be a bridge to heart recovery without the need for a transplant or long-term use of an artificial heart pump. “
Living with Heart Failure
Heart failure is a chronic, progressive disease that affects approximately 6.2 million adults in the United States. It occurs when the heart does not pump blood as efficiently as it needs to, resulting in a lack of blood and oxygen in the rest of the body.
To compensate for this, the heart can enlarge and develop more muscle mass. It pumps faster to increase performance, while blood vessels constrict to increase blood pressure. Although these changes help the body function, over time they cause the heart to wear out.
After all, the body and heart cannot keep up, and the patient may experience fatigue and shortness of breath. Most heart failure patients are asked to make lifestyle changes and take prescribed medications.
In the past, heart failure was not considered reversible. However, researchers at the Utah Health Center were encouraged by the results of their latest study.
The study, which was conducted at six medical centers nationwide, appears in circulation.
Help the heart heal
The researchers tracked 40 patients with advanced heart failure, ages 18 to 59, all of whom required an LVAD to stay alive. Nineteen patients using the combined therapy improved enough that the LVAD could be removed. The researchers found that 90% of these patients were alive one year after removal. After three years, 77% were still alive and doing well.
The LVAD is implanted in the chest with the external battery connected through a connector in the skin. It can be used for a period of time to reduce the stress of heart failure and allow damaged structures to rest and repair. This leads to an improved function, which leads to its removal.
Steven Boyce, MD, a cardiothoracic surgeon at Adventist HealthCare White Oak Medical Center in Silver Spring, Md., Explained that the LVAD decompresses the left ventricle. This leads to less stress on the myocardium, the muscle tissue of the heart.
“Patients with non-ischemic cardiomyopathy would be the best candidates. If the heart muscle has been largely replaced by scar tissue as a result of repeated heart attacks, the chances that they will benefit are much less, ”he said.
The treatment studied is a possible alternative to lifelong LVAD support or heart transplantation and is less stressful for the patient. Dr. Boyce said he has had patients who are not heart transplant candidates and who have been receiving LVADs for over 10 years.
The next step in the researchers’ plan is to find out why and how the treatment works. Attention is directed to the so-called metabolic pathways, the related chemical reactions that take place in the cell. Some paths generate energy, others require it.