Myocardial Alterations in Adrenoreceptors After Ventricular Unloading with a Pulsatile vs a Nonpulsatile Device

We have recently shown that ventricular unloading with an implantable left ventricular assist device (LVAD) leads to improved calcium handling and membrane integrity and redistribution of alpha adrenoreceptors (AARs) and beta- adrenoreceptors (BARs). Here, we used fluorescence deconvolution microscopy to examine the effect of LVAD type (pulsatile vs non-pulsatile) on upregulation and redistribution of adrenoreceptors in core biopsy samples of the myocardium before and after the removal LVAD. We noted no major differences between the pulsatile and non-pulsatile groups; however, an individual patient's 'recovery' in adrenoreceptor numbers depended on the pre-LVAD number of receptors. These findings suggest that ventricular unloading is beneficial regardless of LVAD type; however, the degree of repair and recovery may correlate with the patient's level of ventricular dysfunction at implant and the pre-LVAD number of adrenoreceptors (130).