Fitting heart failure patients with mechanical heart pumps could actually heal their organ and avoid the need for a transplant, scientists have found.
Around 500,000 people in Britain are diagnosed with heart failure each year and if their condition becomes life threatening they often need a left ventricular assist device (LVAD) to keep them alive while they wait for a transplant.
The device takes over the pumping of the main chamber of the heart and is connected to a battery pack which is usually worn by the patient around the waist.
But scientists at Newcastle University have discovered that nearly one in three men fitted with the pumps recovered enough to have it removed, without the need for a transplant. It suggests the device could become a treatment itself, rather than just a last resort before surgery.
"We talk about these devices as a bridge-to-transplant, something which can keep a patient alive until a heart is available for transplantation,” said Dr Djordje Jakovljevic, Senior Research Fellow in Cardiovascular Ageing and Heart Failure within the Institute of Cellular Medicine at Newcastle University.
“However, we knew that sometimes patients recover to such an extent that they no longer need a heart transplant.
"For the first time, what we have shown is that heart function is restored in some patients – to the extent that they are just like someone healthy who has never had heart disease. In effect, these devices can be a bridge to full recovery in some patients."
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To test whether the pumps could aid complete recovery, the Newcastle team conducted a trial on 58 men with severe heart disease who were fitted with LVADs. After an average of 396 days using the device they were tested against 97 healthy men with no known heart disease.
All were asked to walk on a treadmill with a face mask to monitor their oxygen utilisation and heart pumping capability. Nearly one in three recovered enough to allow the device to be removed, while 40 per cent of those men demonstrated heart function which was equivalent to a healthy individual of the same age.
Hundreds of people require a heart transplant every year, but only around 200 operations are carried out annually because of the current organ donor crisis.
The new study suggests that the mechanical pumps may actually aid recovery, and cut down the need for surgery, which even when successful leaves patients requiring immunosuppressive drugs for the rest of their lives so they do not reject the heart.
"It is very difficult to get a heart transplant, especially in the UK, so any alternative treatment is important and recovery of heart function especially so,” added Dr Guy MacGowan, Consultant Cardiologist of Newcastle upon Tyne Hospitals NHS Foundation Trust.
“The UK has a long way to go in comparison with the number of heart transplants in other developed countries.
"We are pioneering a new strategy to use the LVAD to enhance chances of recovery, monitor for signs of recovery, and then use a minimally invasive procedure to disconnect the device."
Charities said the research was ‘encouraging.’
Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: “Severe heart failure is a devastating condition in which patients can often have a worse life expectancy than many cancers. There is no cure; the only option for many is to be put on the heart transplant waiting list.
“This research is extremely encouraging and shows that there may, finally, be hope for people who are living with advanced heart failure.
"But it’s vital we continue funding research into repairing damaged hearts, so that all heart failure patients can benefit, which is why we’re investing £7.5million into regenerative stem-cell based treatments to help save even more lives.”
The average price of a LVAD is approximately £80,000 and the transplant operation is around £69,000, so the two options are also relatively comparable in cost, say the researchers.
Consultant Cardiac Surgeon Professor Stephan Schueler of Newcastle upon Tyne Hospitals NHS Foundation Trust added: "In most cases the device reverses the symptoms of heart failure so that patients feel less short of breath and with less fatigue.
“In a smaller proportion of patients there is actually an improvement in heart function so that the pump can be disconnected or explanted."
The research was published in the Journal of American College of Cardiology.