Is Myocardial Recovery Possible and How Do You Measure It?

Medical and device therapies that reduce heart failure morbidity and mortality also lead to decreased left ventricular volume and mass, and a more normal elliptical shape of the ventricle. These are due to changes in myocyte size, structure, and organization that have been referred to collectively as “reverse remodeling.” Moreover, there are subsets of patients whose hearts have undergone reverse remodeling following mechanical circulatory support with a ventricular assist device (VAD), who are able to be weaned from their VADs, which has been referred to as “myocardial recovery.” Although the term myocardial recovery has been used to describe the reversal of various aspects of the heart failure phenotype following medical and device therapy, there is no consensus with regard to what constitutes myocardial recovery; moreover, the methodology for identifying myocardial recovery in patients is unclear. These topics will be discussed in the current review.