BACKGROUND: Myocardial recovery may occur in @entity1 with @entity712 who are receiving left ventricular assist-device support, but identification of candidates for device removal remains challenging. We hypothesized that on-line quantitative echocardiography during trials of decreased device support alone or in combination with exercise cardiopulmonary testing can assess cardiac recovery to predict successful device removal. METHODS: We studied 18 @entity1 with severe @entity712 , aged 45 +/- 19 years, who received 234 +/- 169 days of assist-device support as a bridge to transplantation. We used echocardiographic automated border detection from mid-ventricular short-axis images and non-invasive arterial pressure to measure beat-to-beat responses in 2 to 5 minute trials of decreased device flow. We also assessed maximal @entity26 consumption in 14 @entity1 who could exercise. RESULTS: Six @entity1 experienced @entity296 and underwent successful device removal; 12 remained device dependent. With transient, low assist-device flow, @entity1 with device removal had increased @entity64 area of 27% +/- 36% vs -24% +/- 12% (p < 0.05) and fractional area change of 51% +/- 13% vs 23% +/- 11% (p < 0.05) in the @entity1 who were device dependent. Estimates of pre-load-adjusted maximal power, a relatively load-independent index, were 6.7 +/- 2.1 mW/cm(4) in @entity1 with successful device removal vs 1.2 +/- 1.2 mW/cm(4) in @entity1 who were device dependent (p < 0.005). Maximal @entity26 consumption was 17.2 +/- 1.4 ml/kg/min in @entity1 with @entity296 vs 13.1 +/- 1.9 ml/kg/min in @entity1 who were device dependent (p < 0.005) and correlated with pre-load-adjusted maximal power (r = 0.89, p < 0.001). Maximal @entity26 consumption >16 ml/kg/min, increased @entity64 area, >40% increase in fractional area change, or pre-load-adjusted maximal power >4.0 mW/cm(4) with low device flow were associated with successful device removal (p < 0.05). CONCLUSIONS: On-line quantitative echocardiography alone or combined with exercise cardiopulmonary testing can assess @entity296 of @entity1 receiving left ventricular assist-device support and has the potential to identify @entity1 who are clinical candidates for device removal.

Non-invasive assessment of XXXX on chronic left ventricular assist device: results associated with successful device removal.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke', 'echocardiographic stroke'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity296 :: ('MESH:D009202', 'Disease') :: ['myocardial recovery'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen']
@entity296 :: (MESH:D009202,Disease) :: ['myocardial recovery']
