{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:16:37Z","timestamp":1791461797265,"version":"4.3.4"},"reference-count":85,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Heart failure represents a dynamic clinical challenge with the continuous rise of a multi\u2010morbid and ageing population. Yet, the evolving nature of mechanical circulatory support offers a variety of means to manage candidates who might benefit from such interventions. This narrative review focuses on the role of the main mechanical circulatory support devices, such as ventricular assist device, extracorporeal membrane oxygenation, Impella and TandemHeart, in the physiological process of ventricular unloading and remodelling in heart failure, highlighting their characteristics, mechanism and clinical outcomes. The outcome measures described include physiological changes (i.e., stroke volume or preload and afterload), intracardiac pressure (i.e., end\u2010diastolic pressure) and extracardiac pressure (i.e., pulmonary capillary wedge pressure). Overall, all the above mechanical circulatory support strategies can facilitate the unloading of the ventricular failure through different mechanisms, which subsequently affects the ventricular remodelling process. These physiological changes start immediately after ventricular assist device implantation. The devices are indicated in different but overlapping populations and operate in distinctive ways; yet, they have evidenced performance to a favourable standard to improve cardiac function in heart failure, although this proved variable for different devices, and further high\u2010quality trials are vital to assess their clinical outcomes further. Both Impella and TandemHeart are indicated mainly in cardiogenic shock and high\u2010risk percutaneous coronary intervention patients; at the time the literature was evaluated, both devices were found to yield a significant improvement in haemodynamics but not in survival. Nevertheless, the choice of device strategy should be based on individual patient factors, including indication, to optimize clinical outcomes.<\/jats:p>","DOI":"10.1113\/ep091796","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T06:40:11Z","timestamp":1728974411000},"page":"1826-1836","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Left ventricular unloading to facilitate ventricular remodelling in heart failure: A narrative review of mechanical circulatory support"],"prefix":"10.1113","volume":"109","author":[{"given":"Fatima","family":"Kayali","sequence":"first","affiliation":[{"name":"University Hospitals Sussex NHS Foundation Trust Brighton and Hove Sussex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owais","family":"Tahhan","sequence":"additional","affiliation":[{"name":"Aston Medical School Aston University Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guglielmo","family":"Vecchio","sequence":"additional","affiliation":[{"name":"University Hospitals Sussex NHS Foundation Trust Brighton and Hove Sussex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6725-6164","authenticated-orcid":false,"given":"Matti","family":"Jubouri","sequence":"additional","affiliation":[{"name":"Hull York Medical School University of York York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6847-4357","authenticated-orcid":false,"given":"Judi M.","family":"Noubani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Jordan University of Science and Technology Irbid Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0498-7095","authenticated-orcid":false,"given":"Damian M.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Neurovascular Research Laboratory, Faculty of Life Sciences and Education University of South Wales Pontypridd UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian M.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael I.","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Barts Heart Centre St Bartholomew's Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1089-3629","authenticated-orcid":false,"given":"Mohamad","family":"Bashir","sequence":"additional","affiliation":[{"name":"Neurovascular Research Laboratory, Faculty of Life Sciences and Education University of South Wales Pontypridd UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030613"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.08.018"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc3101.093903"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/circ.100.suppl_2.Ii-216"},{"issue":"4","key":"e_1_2_12_6_1","first-page":"447","article-title":"Clinical experience with the TandemHeart percutaneous ventricular assist device as a bridge to cardiac transplantation","volume":"35","author":"Bruckner B. A.","year":"2008","journal-title":"Texas Heart Institute Journal"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.05.031"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/pcad.2000.7190"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e3282f9abe7"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.07.065"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.03.29"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2018.1456334"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2019.0188"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.2.231"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV11I12A265"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000660"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytz234"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000755"},{"key":"e_1_2_12_19_1","first-page":"15","volume-title":"Physiology of ventricular interactions during ventricular assistance","author":"Farrar D.","year":"2000"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03444-x"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2021.05.007"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.07.077"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.08.001"},{"issue":"2","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1055\/s-0038-1676369","article-title":"The Impella device: Historical background, clinical applications and future directions","volume":"28","author":"Glazier J. J.","year":"2019","journal-title":"The International Journal of Angiology\u202f: Official Publication of the International College of Angiology, Inc"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(01)00433-3"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1858"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.038"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035566"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60107-0"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1249\/JES.0000000000000303"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7228.167"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000194"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.038269"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.08.613"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.02.006"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.111.962142"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2011.11.007"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199201000-00015"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/1074248406298293"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-2498(03)00057-3"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.967224"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0b013e3182816cb7"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.07.053"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc3501.095215"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2016.10.015"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfq006"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.112632"},{"issue":"7","key":"e_1_2_12_48_1","first-page":"E166","article-title":"Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology","volume":"7","author":"Makdisi G.","year":"2015","journal-title":"Journal of Thoracic Disease"},{"key":"e_1_2_12_49_1","unstructured":"Maly J.(2024).Indications and timing of MCS implant. Retrieved April 17 2024 fromhttps:\/\/www.kardio\u2010cz.cz\/data\/clanek\/421\/dokumenty\/07\u2010kurdejov\u2010maly\u2010mechanicke\u2010podpory.pdf"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.116.004337"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)00953-8"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1610426"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.112.975888"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2021.01.028"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-015-0941-1"},{"key":"e_1_2_12_56_1","volume-title":"Heart failure\u2014What is heart failure?","author":"National Heart, Lung, and Blood Institute","year":"2022"},{"issue":"3","key":"e_1_2_12_57_1","first-page":"94","article-title":"High\u2010risk chronic total occlusion percutaneous coronary interventions assisted with TandemHeart","volume":"32","author":"Neupane S.","year":"2020","journal-title":"The Journal of Invasive Cardiology"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13959"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1152\/advances.2001.25.1.53"},{"key":"e_1_2_12_60_1","volume-title":"Physiology, cardiac preload","author":"O'Keefe E.","year":"2024"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.098194"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12080"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.022"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001680"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11936-010-0093-6"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.33963\/v.kp.97218"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12055-020-00999-w"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21160"},{"key":"e_1_2_12_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.12.052"},{"key":"e_1_2_12_70_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.120.007448"},{"key":"e_1_2_12_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-5922.2009.00081.x"},{"key":"e_1_2_12_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.065"},{"key":"e_1_2_12_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.10.050"},{"key":"e_1_2_12_74_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909938"},{"key":"e_1_2_12_75_1","doi-asserted-by":"publisher","DOI":"10.14797\/mdcj-16-1-27"},{"key":"e_1_2_12_76_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi161"},{"key":"e_1_2_12_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2004.02.017"},{"issue":"5","key":"e_1_2_12_78_1","first-page":"179","article-title":"Effect of physical exercise training on health\u2010related quality of life and exercise tolerance in patients with left ventricular dysfunction","volume":"44","author":"Toda G.","year":"2004","journal-title":"Journal of Cardiology"},{"key":"e_1_2_12_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2020.11.009"},{"key":"e_1_2_12_80_1","doi-asserted-by":"publisher","DOI":"10.1097\/AIA.0b013e3182603ed5"},{"key":"e_1_2_12_81_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.73.3.428"},{"key":"e_1_2_12_82_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht248"},{"key":"e_1_2_12_83_1","volume-title":"What is ECMO?","author":"White A. F. E.","year":"2016"},{"key":"e_1_2_12_84_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu278"},{"key":"e_1_2_12_85_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-2171"},{"key":"e_1_2_12_86_1","article-title":"A review of the Impella devices","volume":"17","author":"Zein R.","year":"2022","journal-title":"Interventional Cardiology (London, England)"}],"container-title":["Experimental Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/EP091796","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T13:57:36Z","timestamp":1732543056000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/EP091796"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,14]]},"references-count":85,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1113\/EP091796"],"URL":"https:\/\/doi.org\/10.1113\/ep091796","archive":["Portico"],"relation":{},"ISSN":["0958-0670","1469-445X"],"issn-type":[{"value":"0958-0670","type":"print"},{"value":"1469-445X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,14]]},"assertion":[{"value":"2024-01-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}