'Artificial Hearts' might Replace Transplantation

The heart has a surprising capacity
to regenerate itself; © PixelQuelle.de

The mechanical devices, known as Left Ventricular Assist Devices (LVADs), are currently used in patients with very severe heart failure whilst they await transplantation. The new study shows that using an LVAD combined with certain drug therapies can shrink the enlarged heart and enable it to function normally once the LVAD is removed.

For the study researchers gave the full combination therapy to 15 severely ill patients. Of these 15, 11 recovered. Of these, 88 percent were free from recurrence of heart disease five years later. Their quality of life was measured as being at nearly normal.

Professor Sir Magdi Yacoub, from the Heart Science Centre at Imperial and the Royal Brompton and Harefield NHS Trust, said: "We are impressed by the dramatic, sustained improvement in the condition of these severely ill patients and we believe that this is due to the additive effects of the particular combination therapy used. The study also highlights the fact that 'end stage' heart failure can be reversed and that the heart has the capacity to regenerate itself. It therefore stimulates the search for other strategies and more therapeutic targets in this expanding field of regenerative therapy".

LVADs work by being connected to the left ventricle of the heart, either directly or by a tube. They remove oxygen rich blood from the left ventricle and take the blood to a mechanical pump. The mechanical pump then pumps the oxygen rich blood into another tube which is connected to the aorta. Once blood is in the aorta, it can be transported to the rest of the body.

Patients were treated with drugs which encourage reverse remodelling of the heart, prevent atrophy and prevent the heart from shrinking beyond its desirable size. The drugs used were lisinopril, carvedilol, spironolactone and losartan in the first stage of treatment and bisoprolol and clenbuterol in the second.

MEDICA.de; Source: Imperial College London