Resting the heart using combined mechanical and drug therapy can reverse the damage caused by heart failure and lead to a recovery in some patients, according to research by our cardiologists published in the New England Journal of Medicine.  The research provoked intense media interest, holding out new hope to many sufferers of heart failure.

 

Heart failure is a major cause of death and disability, affecting approximately 750,000 people in the UK. Over the past decade, mechanical devices called Left Ventricular Assist Devices (LVADs), or artificial hearts, have been increasingly used in the most severely affected patients while they wait for a heart transplant.

 

Recovery without transplantation

 

As the use of LVADs increased, evidence began to emerge which showed that some patients with the devices were recovering without the need for transplant however this recovery was not sustained long-term.

 

The Harefield hospital study was initiated by Professor Magdi Yacoub and designed to identify how LVADs and drug therapy could be used together to enable the heart to recover to a point where it could work effectively without assistance and without a recurrence of heart failure.

 

 

Dr Emma Birks, cardiology consultant and lead researcher, explained: “The combination drug therapy consisted of two stages. In the first stage we used drugs to shrink the hearts of patients with LVADs, as they become enlarged due to heart failure, and then we used drugs to strengthen the heart.”

 

Patients were monitored frequently and showed significant clinical improvements in blood flow and exercise capacity. Once patients had satisfactory heart function with the device switched off for 15 minutes, the LVADs were taken out.

 

In addition, patients’ quality of life became normal.  Approximately 75 per cent of patients who received a full course of the combination therapy recovered and of these, 88.9 per cent were free from recurrence of heart disease five years later.

 

Improved health outcomes

 

“It is very encouraging that we have been able to prove combination therapy can heal the heart. What is even more encouraging however is that we have shown that this recovery can be sustained for at least five years – vastly improving the health outcomes for our patients,” said Dr Birks.

 

“Donor heart transplant has for many years been the gold standard in the treatment of those with severe heart failure. It has proven greatly successful but is not without its shortcomings – particularly the shortage of donor hearts and the risk of organ rejection.

 

“This combined therapy has the potential to ease the pressure on the waiting list while also offering patients a better alternative to a donor heart – their own, healthy heart.”  

 

Learn more

Watch Dr Emma Birks explain LVADs in our online video.Read a patient's account of his recovery with an LVAD. Read coverage of our research in the Times, BBC News Online or Medpage Today for an in-depth article.