Advanced heart failure in the 21st century: new physiological insights and new therapeutic avenues

Countries with developed economies are currently facing an epidemic of heart failure (HF) and the prognosis of patients with advanced HF remains extremely poor. One of the therapeutic options for patients with advanced HF is heart transplant. The number of cardiac transplants performed in USA and other states each year has stagnated despite an increasing number of cases of end-stage heart failure each year, primarily due to limited donor supply. Therefore, novel therapies for cardiac replacement (such as left ventricular assist devices, LVADs), other cardiac assistance devices including arrhythmia treatment (cardiac resynchronization therapy, CRT or implantable cardiac defibrillators (ICDs) have been tested and are being used in clinical practice. Moreover, stem cell therapy has been tested as well as a role of endogenous progenitor cells has been explored. However, effects of the novel therapeutic approaches or their combination on pathophysiology of HF as well the involvement of endogenous progenitor cells are incompletely understood, which requires further research. The main aims of the thesis with corresponding main hypotheses were three as follows. First, to study the physiological effects of LVADs on pulmonary vascular resistance and the incidence and clinical tolerance of ventricular..