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Stem Cell and Left Ventricular Assist Device Combination Therapy
Circulation: Heart Failure ( IF 9.7 ) Pub Date : 2019-02-14 , DOI: 10.1161/circheartfailure.118.005454
Gregor Poglajen 1, 2 , Igor D. Gregoric 2 , Rajko Radovancevic 2 , Bojan Vrtovec 1
Affiliation  

Ventricular assist device (VAD) technology has evolved significantly over the past decades and currently represents one of the most important treatment strategies for patients with advanced chronic heart failure. There is increasing evidence that in selected patients undergoing long-term VAD support, improvement of myocardial structure and function may occur. However, there seems to be a significant discrepancy between structural and functional recovery of the failing myocardium, as only a small fraction of VAD-supported patients demonstrate reverse structural remodeling and eventually reach clinically significant and stable, functional improvement. More recently, cell therapy has gained a growing interest in the heart failure community because of its potential to augment reverse remodeling of the failing myocardium. Although theoretically the combination of long-term VAD support and cell therapy may offer significant advantages over using these therapeutic modalities separately, it remains largely unexplored. This review aims to summarize the current state of the art of the effects of VAD support and cell therapy on the reverse remodeling of the failing myocardium and to discuss the rationale for using a combined treatment strategy to further promote myocardial recovery in patients with advanced chronic heart failure.

中文翻译:

干细胞和左心室辅助装置联合治疗

在过去的几十年中,心室辅助设备(VAD)技术得到了长足的发展,目前已成为晚期慢性心力衰竭患者最重要的治疗策略之一。越来越多的证据表明,在接受长期VAD支持的特定患者中,可能会改善心肌的结构和功能。然而,由于只有一小部分由VAD支持的患者表现出反向的结构重构,并最终达到临床上显着且稳定的功能改善,心肌衰竭的结构和功能恢复之间似乎存在巨大差异。最近,由于细胞疗法有可能增强衰竭心肌的反向重塑,因此它在心力衰竭领域引起了越来越多的兴趣。尽管从理论上说,长期VAD支持和细胞疗法相结合可能比单独使用这些治疗方式具有明显的优势,但在很大程度上尚待探索。这篇综述旨在总结VAD支持和细胞治疗对衰竭的心肌逆向重构的影响的最新技术,并讨论使用联合治疗策略进一步促进晚期慢性心脏病患者心肌恢复的基本原理失败。
更新日期:2019-02-14
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