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American Heart Association

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Final ID: MDP244

A meta-analysis of myocardial recovery and its associated factors in advanced heart failure with left ventricular assist device

Abstract Body (Do not enter title and authors here): Introduction:
Patients with advanced heart failure use left ventricular assist devices (LVAD) to improve their outcomes and enhance the reverse remodeling of the heart. There has been no previous meta-analysis on the percentage or predictors of myocardial recovery after LVAD according to the device strategy. This study aims to find the pooled percentage and determinants of myocardial recovery after LVAD.
Methods:
A systematic search was done in PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to April 2024. We used relevant keywords to include the studies that reported the percentage of people who have achieved myocardial recovery after LVAD. The percentage of participants using LVAD and achieved myocardial recovery was extracted and pooled results were stratified according to the device strategy. RevMan 5.4 was used for the meta-analysis.
Results:
We included 30 studies comprising 38708 patients with various LVADs used among the participants. Across the studies, multiple terms for myocardial recovery were used, most commonly being device explant following myocardial recovery and achieving left ventricular ejection fraction (LVEF) ≥40% after using LVAD. The overall pooled percentage of people who achieved myocardial recovery was 4.61% (95% CI [3.77, 5.45]), and the result was heterogeneous (I2 = 93%, p <0.00001). The percentage of myocardial recovery in patients implanted as a bridge to recovery (BTR) was 24.8%, 11.1% for a bridge to transplant (BTT) and 2.9% for mixed device strategy (Figure 1). Shorter duration of heart failure, female gender, younger age, absence of implantable cardioverter-defibrillator (ICD), and low left ventricular end-diastolic diameter (LVEDD) were the most cited factors associated with myocardial recovery.
Conclusion:
Myocardial recovery following LVAD is low and was found to be high in patients implanted for BTR. Several factors have been identified as potential predictors of myocardial recovery in patients on LVAD therapy. Further action should be taken to improve the recovery among this population.
  • Hasabo, Elfatih A.  ( University of Galway , Galway , Ireland )
  • Soliman, Osama  ( University of Galway, Ireland , Galway , Ireland )
  • Isik, Burce  ( University of Limerick , Limerick , Ireland )
  • Bakr, Mohamed  ( New Mansoura University , New Mansoura , Egypt )
  • Mahmmoud Fadelallah Eljack, Mohammed  ( WadMedani Heart Disease and Surgery , Wad Medani , Sudan )
  • Neiroukh, Dina  ( University of Galway , Galway , Ireland )
  • Nosir, Mahmoud  ( University of Galway , Galway , Ireland )
  • Ayhan, Cagri  ( University of Galway , Galway , Ireland )
  • Sultan, Sherif  ( University of Galway , Galway , Ireland )
  • Caliskan, Kadir  ( Erasmus MC University Medical Center , Rotterdam , Netherlands )
  • Author Disclosures:
    Elfatih A. Hasabo: DO NOT have relevant financial relationships | OSAMA SOLIMAN: DO have relevant financial relationships ; Research Funding (PI or named investigator):Boston Scientific:Active (exists now) ; Consultant:Abbott:Active (exists now) ; Research Funding (PI or named investigator):Meril Life Science:Active (exists now) ; Research Funding (PI or named investigator):Biosensors:Active (exists now) | Burce Isik: DO NOT have relevant financial relationships | Mohamed Bakr: No Answer | Mohammed Mahmmoud Fadelallah Eljack: DO NOT have relevant financial relationships | Dina Neiroukh: DO NOT have relevant financial relationships | Mahmoud Nosir: No Answer | Cagri Ayhan: No Answer | Sherif Sultan: No Answer | Kadir Caliskan: No Answer
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

The Rise of the Machines: Mechanical Circulatory Support in 2024 and Beyond

Saturday, 11/16/2024 , 12:50PM - 02:15PM

Moderated Digital Poster Session

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