Recovery from XXXX with circulatory assist: a working group of the National, Heart, Lung, and Blood Institute.

@entity1 @entity712 @entity65
BACKGROUND: Over the past decade, mechanical circulatory support has been beneficial as a bridge to cardiac transplantation, and anecdotal evidence suggests that @entity712 @entity1 fitted with mechanical assist devices experience direct cardiac benefits. Moreover, recent trials on limited numbers and subpopulations of @entity1 --notably the Randomized Evaluation of Mechanical Assistance for the Treatment of @entity712 (REMATCH)--support earlier observations of improved cardiac function and point towards the use of assist devices as destination therapy. Methods and results To investigate this phenomenon, on August 2-3, 2001, the National Heart, Lung, and Blood Institute convened the working group, "Recovery from @entity712 with Circulatory Assist" in Bethesda, Maryland. The team included cardiac surgeons, cardiologists, and experts in experimental research. The goal was to prioritize recommendations to guide future programs in: (1). elucidating the mechanisms leading to reverse remodeling associated with a left ventricular assist device (LVAD); (2). exploring advanced treatments, including novel pharmacologies, tissue engineering, and cell therapies, to optimize recovery with LVAD therapy; and (3). identifying target genes, proteins, and cellular pathways to focus on for production of novel therapies for myocardial recovery and @entity65 . CONCLUSIONS: The working group also made research and clinical recommendations to eventually translate findings into improved therapeutic strategies and device design: (1). support collaborations among clinical and basic scientists with an emphasis on clinical/translational research that might eventually lead to clinical trials; (2). identify candidate @entity1 most likely to benefit from LVAD as a destination therapy; (3). explore potential biomarkers indicating when @entity1 could most successfully be weaned from devices; and (4). promote clinical and experimental study of mechanically assisted organs and the tissue derived from them.
