Can reducing mechanical stress placed on the heart help heart failure treatments to work?

Mechanosensitivity of the failing myocardium: role of mechanical unloading

Every year, a significant number of deaths are caused by heart failure in the UK. This research to understand if mechanical devices could help hearts to repair themselves could reveal new ways to treat patients in the future. Scientists believe that high levels of mechanical stress placed on the heart can contribute to heart failure and how it progresses, and partly explain why people often do not respond to treatments. Because the heart cannot repair itself once it is damaged, people with heart failure ultimately need a heart transplant. Until a suitable donor organ is found, doctors currently use mechanical pumps and left ventricular assist devices (LVADs) to take the strain off the heart and keep people with heart failure alive. Aside from physically helping the heart to pump efficiently, these devices may also help the heart recover – by allowing a period of ‘rest’ by mechanically unloading the heart, reducing wall stress and even improving heart function. But if these devices are used for too long, they can be damaging to the heart. The BHF has now awarded a grant to Dr Cesare Terracciano and his team to unravel exactly how these devices work, find out whether this mechanical unloading can help heart failure therapies to work, and what the best time frame for repair is. They will look at the structure of the heart and how the heart functions to work out if mechanical unloading can actually help the heart to repair itself. This research may reveal new ways to treat people with heart failure.