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Current Heart Failure Reports

, Volume 15, Issue 4, pp 250–259 | Cite as

The Effect of Left Ventricular Assist Device Therapy on Cardiac Biomarkers: Implications for the Identification of Myocardial Recovery

  • Luise Holzhauser
  • Gene Kim
  • Gabriel Sayer
  • Nir Uriel
Biomarkers of Heart Failure (W Tang and J Grodin, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Biomarkers of Heart Failure

Abstract

Purpose of Review

Left ventricular assist device (LVAD) therapy serves as mainstay therapy for bridge to transplantation and destination therapy. Evidence is now mounting on the role of LVAD therapy as bridge to recovery. In the current review, we will summarize the data on biomarkers of myocardial recovery following LVAD implantation.

Recent Findings

Myocardial recovery can occur spontaneously, following pharmacological intervention and in the setting of mechanical circulatory support such as LVAD. Several biomarkers such as B-type natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), ST2, etc. have been identified and are being used to guide medical therapy in heart failure (HF) patients. However, recent data raised concern that those biomarkers may not be helpful in managing heart failure patients in general, and as such questioned their use in the advanced heart failure population. At this point, the use of biomarker to identify patients with myocardial recovery during LVAD support has not been established, and LVAD explantation remains a decision driven by echocardiographic and hemodynamics improvement.

Summary

HF biomarkers in monitoring myocardial and neurohormonal activation response to mechanical unloading and medical therapy could be valuable. However, at this time, there is inadequate evidence to select a single or a set of HF biomarkers to reliably identify patients bridged to recovery for LVAD explantation.

Keywords

Heart failure Biomarkers Left ventricular assist device (LVAD) Myocardial recovery 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Luise Holzhauser
    • 1
  • Gene Kim
    • 1
  • Gabriel Sayer
    • 1
  • Nir Uriel
    • 1
  1. 1.Department of Medicine, Division of CardiologyUniversity of ChicagoChicagoUSA

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