Another Grain in the Search for the True Rate of Myocardial Recovery ∗

Advanced heart failure (HF) is rarely thought of as a reversible process; however, mechanical unloading using a left ventricular assist device (LVAD) has been shown to promote reversal of the HF phenotype, with regression of pathologic myocardial hypertrophy and improvement in both left ventricular (LV) chamber size and LV function, a process called "reverse remodeling." This process can be significant and may result in myocardial recovery; that is, the normalization of functional, structural, and hemodynamic changes sufficient to allow sustained explantation of the LVAD. Improvements are seen at the clinical, molecular, and cellular levels (1).

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