OBJECTIVES: During support with a left ventricular assist device (LVAD), partial reverse remodelling takes place in which fibrosis plays an important role. In this study, we analysed the histological changes and expression of fibrotic markers in patients with advanced heart failure (HF) during continuous-flow LVAD (cf-LVAD) support. METHODS: In 25 patients, myocardial tissue at the time of LVAD implantation (pre-LVAD) was compared with tissue from the explanted left ventricle (post-LVAD). Interstitial fibrosis and cardiomyocyte size were analysed pre-and post-LVAD. Plasma was obtained from all patients before and during LVAD support. Plasma levels, cardiac mRNA and protein expression of brain natriuretic peptide (BNP), galectin-3 (Gal-3), connective tissue growth factor (CTGF), osteopontin (OPN) and transforming growth factor beta-1 were determined. RESULTS: Fibrosis increased during cf-LVAD unloading (P investigation.
Lok, S. I., Nous, F. M. A., van Kuik, J., van der Weide, P., Winkens, B., Kemperman, H., Huisman, A., Lahpor, J. R., de Weger, R. A., & de Jonge, N. (2015). Myocardial fibrosis and pro-fibrotic markers in end-stage heart failure patients during continuous-flow left ventricular assist device support. European Journal of Cardio-Thoracic Surgery, 48(3), 407-415. https://doi.org/10.1093/ejcts/ezu539