Heart disease is a leading cause of death and disability in the United States. While treatments do exist for the prevention of further heart damage, there comes a point where the only option left is for the cardiovascular disease patient to receive a heart transplant. However, these vital organs don’t simply grow on trees, and there is often a shortage of donated hearts for transplant. But perhaps the use of mechanical heart pumps can quell this need—they could be a tool to allow patients to restore their health.
This is exactly what lead author Dr. Djordje Jakovljevic set out to accomplish. He and his research team examined the effect of mechanical heart pumps, known as left ventricular assist devices (LVAD), to assess whether this tool can be used as a long-term treatment option.
Mechanical pumps are devices used to support people with severe heart failure while they wait for a heart transplant. They require a surgeon to implant a battery-operated mechanical pump in the heart that helps maintain the pumping chamber—the left ventricle.
“We talk about these devices as a bridge-to-transplant, something which can keep a patient alive until a heart is available for transplantation. However, we knew that sometimes patients recover to such an extent that they no longer need a heart transplant,” Dr. Jakovljevic said.
The study in question consisted of a clinical trial where 58 men with heart failure were tested for their heart fitness level. Sixteen of the men were fitted with a mechanical heart pump and then had it removed due to the extent of their recovery. Furthermore, 18 men still had a mechanical heart pump and 24 men were waiting for a heart transplant. On average, a patient had a device fitted for 396 days before it was removed, varying from 22 to 638 days.
The patients in this study were compared to 97 healthy men without any known heart disease. All the men were tested using a treadmill test with a face mask to monitor oxygen utilization and heart pumping capability. The researchers reported that 38 percent of people recover enough to allow the device to be removed, demonstrating a heart function that was equivalent to that of a healthy individual of the same age
“For the first time, what we have shown is that heart function is restored in some patients – to the extent that they are just like someone healthy who has never had heart disease. In effect, these devices can be a bridge to full recovery in some patients,” said Dr. Jakovljevic. “We can consider these pumps as a tool which can lead to a patient recovering, rather than as a device which keeps people alive until a heart transplant is available”
These study results will spark more ongoing research for Dr. Jakovljevic and his team, who want to identify the markers of early heart recovery in patients fitted with mechanical heart pumps. They hope that these markers will inform health professionals to make the right decisions as to which patients will respond well to the utilization of a mechanical heart pump for end-stage heart failure.