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Project

Mechanical ventricular support in chronic heart failure. Reversed remodeling and the renin-angiotensin-aldosterone-system.

Cardiac failure is a common and progressive disease. Despite new developments in medical treatment the progression can only be delayed but not prevented and the failing heart cannot be cured. Many patients evolve to end)stage cardiac failure in which cardiac transplantation is the only curative option left. Donor hearts are sparse and not directly available to a transplant candidate. Therefore some patients awaiting transplantation need a mechanical assist device to support their failing heart when they are on a waiting list (bridge-to-transplantation). Recent clinical and experimental trails have shown that in some cases there is a functional recovery of the failing heart when supported even to a point where explantation of the assist device is feasible (bridge-to-recovery / reversed remodeling).
In sheep we will create cardiac failure by means of an infarction. Biochemical and hemodynamic measurements we be done before creation of the infarction, 6 weeks after infarction. Subsequently some animals will receive a mechanical assist device(Synergy micro-pump, CircuLite Inc., partial support pump). A second group of animals will receive a mechanical assist device and ACE-inhibitors. A third group wont receive any treatment at all and will serve as a control. After 6 weeks of support the hemodynamic measurements will be repeated. Afterwards the hearts are explanted and histological investigated.
 
The aim of the study is to examine the effect of partial mechanical support on the left ventricle in cardiac failure (reversed remodeling) and the effects of ACE-inhibitors on this reversed remodeling process.
Date:7 Sep 2009  →  20 Sep 2019
Keywords:Cardiac failure
Disciplines:Orthopaedics, Surgery, Nursing, Cardiac and vascular medicine
Project type:PhD project