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Recent studies suggest that further pharmacological neurohormonal blockade may not be safe or effective, which has driven development of devices for this patient population. Furthermore, such devices may target fundamental pathophysiological abnormalities that are largely hemodynamic and mechanical in nature that are not addressed by available pharmacological agents. The profound reverse remodeling routinely associated with left ventricular assist device use, reviewed in detail, further validates device-based approaches and should inspire research to find ways to make this recovery more complete and permanent. Accordingly, this review focuses on the multitude of mechanical device\u2013based approaches currently being investigated to manage and treat this population. From devices for monitoring patient status to anticipate congestive heart failure exacerbations and preemptively adjust therapy to devices to support preterminal patients with end-stage disease, it is recognized that these device-based approaches will assume an increasingly important role in treating the growing number of patients with advanced heart failure.<\/jats:p>","DOI":"10.1161\/circulationaha.104.481259","type":"journal-article","created":{"date-parts":[[2005,7,18]],"date-time":"2005-07-18T22:27:44Z","timestamp":1121725664000},"page":"438-448","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Mechanical Device\u2013Based Methods of Managing and Treating Heart Failure"],"prefix":"10.1161","volume":"112","author":[{"given":"Donna","family":"Mancini","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Columbia University Medical School, New York (D.M., D.B.), and IMPULSE Dynamics, Orangeburg (D.B.), NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Burkhoff","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Columbia University Medical School, New York (D.M., D.B.), and IMPULSE Dynamics, Orangeburg (D.B.), NY."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250502"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199605233342101"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105313442201"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030207"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)04440-2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000124490.27666.b2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010713"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013168"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-9-200405040-00013"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2004.02.027"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.1996.tb00019.x"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70288-5"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.113598"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.112633"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70242-9"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01119-6"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.116208"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70141-7"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.91.9.2314"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(93)90400-C"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01890-9"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002480-200205000-00012"},{"key":"e_1_3_2_25_2","first-page":"S26","volume":"11","year":"2002","unstructured":"Bolling SF. 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