Abstract
Background: The serial effects of continuous-flow left ventricular assist devices (LVADs) on the diastolic function of the failing human heart are not known. We sought to evaluate the effects of continuous-flow mechanical unloading on the diastolic function of the failing heart. Methods: Consecutive patients with baseline characteristics consistent with end-stage chronic heart failure referred for LVAD implantation as a bridge to transplantation or destination therapy between 2008 and 2011 were prospectively enrolled. Serial echocardiograms were performed at the time of LVAD implant and at pre-defined time points during the first year of LVAD support. Results: Eighty patients (age 56±16 years, 80% males) formed the study group and the main echocardiographic findings are summarized in the Table. Effective and sustained unloading (Figure-panel A) was achieved by CF-LVADs as evaluated by the E/E’ ratio. Similarly, diastolic function improved as early as 1 month after LVAD implant and changes were sustained over a year period (Figure-panel B). Further, these changes were sustained under increased loading conditions (turn down echocardiograms). Conclusions: Continuous-flow LVADs effectively unload the left ventricle and improve its diastolic function. These findings might be important in the new and rapidly growing field of LVAD induced myocardial recovery.
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