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Device Plus 'Aggressive' Drug Strategy May Curb Severe Heart Failure
Small study suggests real improvement for some patients, but more follow-up research is needed

By Robert Preidt

SUNDAY, Nov. 13, 2016 (HealthDay News) -- A combination of an implanted heart device and intensive drug therapy may help boost heart function in end-stage heart failure patients, preliminary results of an ongoing study suggest.

The research focused on 36 patients who were implanted with what's known as a left ventricular assist device (LVAD), a kind of heart pump.

"Patients who receive this assist device generally are in line to receive a heart transplant," explained cardiologist Dr. Michael Kim, who reviewed the new findings.

"Because there are not nearly enough hearts available for transplantation relative to the need for heart transplantation, these newer assist devices can keep these sick patients alive until a heart does become available, sometimes for years," said Kim. He directs interventional cardiology at Lenox Hill Hospital in New York City.

The new study was led by Dr. Emma Birks, professor of medicine at the University of Louisville. Besides receiving the LVAD, patients in the study were also prescribed an aggressive regimen of five different drugs: lisinopril (Prinivil); spironolactone (Aldactone); digoxin (Lanoxin); losartan (Cozaar); and carvedilol (Coreg).

With this combined therapy, 13 (nearly one-third) of the patients recovered enough heart function after an average of 344 days to have the LVAD pump removed, the researchers said. Two patients who still had pumps received needed heart transplants, and one who still had a pump died, according to the report.

The 20 other patients still have their pumps, but two are scheduled to have their devices removed, the study authors said. The findings were scheduled for presentation Sunday at the American Heart Association's annual meeting, in New Orleans.

The results suggest "that even very advanced heart failure can be reversed using these heart pumps, particularly when combined with additional drug therapy, avoiding the need for heart transplantation for these patients and making the donor heart available for another needy individual," Birks said in a heart association news release.

"The fact that this could be done in several centers suggests that using the device with this drug combination to reverse heart failure is possible on a larger scale," she added. "It has previously been thought that these devices rarely recover heart function enough to allow them to be removed, but this study suggests that this can occur in a much bigger number than originally thought, particularly if combined with drug therapy."

Kim was encouraged by the findings, but stressed that the study was small and "more follow-up is needed to confirm this observation." Experts also note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Dr. David Friedman is chief of congestive heart failure services at North Shore-LIJ's Franklin Hospital in Valley Stream, N.Y. He called the study "very positive preliminary research," which shows that "strategies used to help advanced heart failure patients definitely help to try to have patients get improved overall clinical outcomes and better quality of life going forward."

More information

The U.S. National Heart, Lung, and Blood Institute has more on heart failure.

SOURCES: Michael Kim, M.D., director, cardiac cath labs and interventional cardiology, Lenox Hill Hospital, New York City; David Friedman, M.D., chief, congestive heart failure services, North Shore-LIJ's Franklin Hospital, Valley Stream, N.Y.; American Heart Association, news release, Nov. 13, 2016

Copyright © 2016 HealthDay. All rights reserved. URL:http://consumer.healthday.com/Article.asp?AID=716491

Resources from HONselect: HONselect is the HON's medical search engine. It retrieves scientific articles, images, conferences and web sites on the selected subject.
Heart
Heart Failure, Congestive
Equipment and Supplies
Association
Transplantation
Drug Therapy
Transplants
Losartan
Digoxin
Heart Transplantation
Lisinopril
Spironolactone
The list of medical terms above are retrieved automatically from the article.

Disclaimer: The text presented on this page is not a substitute for professional medical advice. It is for your information only and may not represent your true individual medical situation. Do not hesitate to consult your healthcare provider if you have any questions or concerns. Do not use this information to diagnose or treat a health problem or disease without consulting a qualified healthcare professional.
Be advised that HealthDay articles are derived from various sources and may not reflect your own country regulations. The Health On the Net Foundation does not endorse opinions, products, or services that may appear in HealthDay articles.


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