Negative Impact of Acute Reloading after Mechanical Left Ventricular Unloading

Renata Mazurek, Taro Kariya, Tomoki Sakata, Spyros A. Mavropoulos, Anjali J. Ravichandran, Francisco J. Romeo, Kelly P. Yamada, Kiyotake Ishikawa

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Mechanical LV unloading for acute myocardial infarction (MI) is a promising supportive therapy to reperfusion. However, no data is available on exit strategy. We evaluated hemodynamic and cellular effects of reloading after Impella-mediated LV unloading in Yorkshire pigs. First, we conducted an acute study in normal heart to observe effects of unloading and reloading independent of MI-induced ischemic effects. We then completed an MI study to investigate optimal exit strategy on one-week infarct size, no-reflow area, and LV function with different reloading speeds. Initial studies showed that acute reloading causes an immediate rise in end-diastolic wall stress followed by a significant increase in cardiomyocyte apoptosis. The MI study did not result in any statistically significant findings; however, numerically smaller average infarct size and no-reflow area in the gradual reloading group prompt further examination of reloading approach as an important clinically relevant consideration. Graphical abstract: (Figure presented.)

Original languageEnglish
Pages (from-to)233-241
Number of pages9
JournalJournal of Cardiovascular Translational Research
Issue number2
StatePublished - Apr 2024


  • Acute myocardial infarction
  • Cardiomyocyte apoptosis
  • Mechanical left ventricle unloading
  • Reloading
  • Weaning


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