Mayo Clinic is announcing results of a study on the effectiveness of left-ventricular assist devices (LVAD) in treating patients with a form of cardiomyopathy called restrictive cardiomyopathy (RCM). The Mayo Clinic study, which is the largest study of its kind to date, demonstrates that LVAD devices are a viable and accessible option for treating patients with RCM, who would otherwise see their health deteriorate or who may not survive. The study suggests criteria that clinicians can use for successful implementation of these devices in RCM.
Approximately 500,000 people are currently living with cardiomyopathy, which is a condition that affects the muscles in the heart. RCM is a rare form of cardiomyopathy that limits the heart muscle from relaxing between beats when the blood returns from the body back to the heart. This causes the heart to pump weakly and restricts the flow of blood to the heart's chambers. An LVAD is a mechanical pump that helps pump blood from the heart to the rest of the body.
This study, which was conducted by Mayo Clinic specialists in the Division of Cardiovascular Diseases, the Division of Cardiovascular Surgery and the Department of Health Sciences Research, was published in the Journal of Heart and Lung Transplantation.
"As a result of Mayo Clinic research, we now know we can improve clinical outcomes for patients with end-stage restrictive cardiomyopathy by using a left-ventricular assist device, which has become a standard therapeutic device for treating heart failure in dilated and ischemic cardiomyopathy. This is promising news, because patients with RCM have few therapeutic options and we continue to face donor shortages for transplant patients" says Sudhir Kushwaha, M.D., medical director of Cardiac Transplantation and Mechanical Circulatory Support at Mayo Clinic in Rochester, Minnesota.
The study was conducted using data from 28 patients with end-stage heart failure who had received a continuous-flow LVAD between January 2008 and August 2013, as a treatment bridge until a heart transplant could be conducted or who were not heart transplant candidates. Mayo Clinic cardiologists studied each patient's preoperative data, short-term postoperative events, and long-term results. The research team reported improved survival rates and fewer complications in patients who received an LVAD device, whether they had eventually received a heart transplant or not.
"While other studies have focused on risk factors associated with post-LVAD survival, this is the first study to focus exclusively on end-stage RCM patients and to identify the parameters associated with better outcomes," says Lyle Joyce, M.D., Ph.D., heart transplant surgeon and surgical director of Mayo Clinic's VAD program. "For example, we have defined criteria such as size of the left ventricle which is very important in determining outcome in these patients suggesting that with careful selection we can offer these patients a much better outcome and eventual cardiac transplantation."
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