Prolonged Impella support (PROPELLA concept) in fulminant myocarditis decreased cardiac immune cell presence and integrin expression during left ventricular unloading.
Does prolonged Impella support (PROPELLA concept) alter cardiac immune cell presence and integrin expression in fulminant myocarditis?
Prolonged Impella support in fulminant myocarditis may provide disease-altering effects by reducing cardiac inflammation and integrin expression, potentially enhancing myocardial recovery.
AIMS: Haemodynamic load induces cardiac remodelling via mechano-transduction pathways, which can further trigger inflammatory responses. We hypothesized that particularly in an inflammatory disorder such as myocarditis, a therapeutic strategy is required which, in addition to providing adequate circulatory support, unloads the left ventricle, decreases cardiac wall stress, and mitigates inflammatory responses. METHODS AND RESULTS: Axial flow pumps such as the Impella systems comply with these requirements. Here, we report a potential mode-of-action of prolonged Impella support (PROPELLA concept) in fulminant myocarditis, including a decrease in cardiac immune cell presence, and integrin α1, α5, α6, α10 and β6 expression during unloading. CONCLUSION: PROPELLA may provide benefits beyond its primary function of mechanical circulatory support in the form of additional disease-altering effects, which may contribute to enhanced myocardial recovery/remission in patients with chronic fulminant myocarditis.
“Like with ECMO, the Impella device also provides circulatory support, but the heart is unloaded. The Impella, which is implanted in the left ventricle, acts like a propeller in a boat. It swaps the blood out, so the heart does not have to pump. This reduces the volume load, and therefore reduces the stress for the heart.”
Spillmann et al. (Thu,) conducted a other in Fulminant myocarditis. Prolonged Impella support (PROPELLA concept) was evaluated on Cardiac immune cell presence and integrin expression. Prolonged Impella support (PROPELLA concept) in fulminant myocarditis decreased cardiac immune cell presence and integrin expression during left ventricular unloading.
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