Heart failure (HF) is a major public health problem in the United States, and its prevalence is likely to increase with the aging U.S. population. Mechanical circulatory support (MCS) utilizing bladder-based blood pumps generating pulsatile flow has been reserved for patients with severe HF failing medical therapy. As MCS technology has advanced to include rotary blood pumps, so has our understanding of the biological and clinical responses to MCS, which in turn has altered the risk/benefit profile of this therapy. This may lead to paradigm shifts in device usage from support of end-stage HF to temporary support for recovery of cardiac function and earlier usage, to, ultimately, prevention of disease progression. This review serves to explore the current state and future opportunities of MCS within our larger understanding of the epidemiology, pathophysiology, and treatment options for HF.

中文翻译：

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使用机械循环支持装置的当前和未来考虑。

心力衰竭 (HF) 是美国的主要公共卫生问题，随着美国人口老龄化，其患病率可能会增加。利用基于膀胱的血泵产生脉动流的机械循环支持 (MCS) 已保留用于药物治疗失败的严重 HF 患者。随着 MCS 技术的进步，包括旋转式血泵，我们对 MCS 的生物学和临床反应的理解也随之发展，这反过来又改变了这种疗法的风险/收益概况。这可能导致设备使用的范式转变，从支持终末期 HF 到临时支持恢复心脏功能和早期使用，最终预防疾病进展。本综述旨在在我们对流行病学的更广泛理解中探索 MCS 的现状和未来机会，