U.S. researchers haven’t been able to replicate those results. Birks said that may have to do with the fact that the Harefield study, unlike its U.S. counterparts, involved patients with weakened hearts but no clogging of the arteries. The English study also used clenbuterol, a muscle-building steroid banned for human use in the United States.
A U.S. study that began about six months ago will test whether therapeutic use of modern heart pumps, together with aggressive drug therapy, can restore damaged hearts, Birks said. Then, perhaps, researchers will get permission to try clenbuterol again, along with other therapies, she said.
About half of the people suffering from congestive heart failure have normal arteries, Birks said. She hopes to show that about half of those could recover to the point that they won’t need heart pumps.
While there’s great enthusiasm for the concept of using pumps to restore weakened hearts, “in practice it’s relatively uncommon,” according to Dr. Peter Eckman, medical director of the University of Minnesota’s mechanical circulatory support program.
Sun agreed. Just two patients treated at Abbot have had their pumps removed so far, he said.
The U’s program is following more than 100 patients, Eckman said, adding that he can think of just three whose hearts have strengthened to the point where their pumps could be removed.
Not everyone likes the idea — even where it’s possible.
Richard Balzum, 48, of Buffalo, Minn., has been living with a heart pump since February 2011. His heart has recovered to the point where it’s stronger than an average heart, Eckman said, but Balzum is opting to stick with the pump.
Balzum said that he’s HIV-positive and that he doesn’t want to take a chance on a surgery that might lead to an infection. “Why risk taking it out?” Balzum said. “I don’t have any concerns on the reliability of this device.”
No one has a reliable formula for nursing damaged hearts back to health, due partly to the fact that heart failure has many different causes.
Eckman said some people sporadically get better and no one knows why. “That’s the million-dollar question, ” he said.
A surprise recovery
Sun remembers the first time he encountered a heart that had recovered after the implantation of a heart pump. He was working under the famed surgeon Mehmet Oz at Columbia University in New York.
“I went to the operating room ready to do a heart transplant on a guy. When I opened his chest up, his heart was virtually normal on a heart pump. And I went, ‘Holy crap!’ ”
Sun removed the pump, and the donor heart went to another patient.
The same sort of thing happened in a half-dozen more cases in the mid-1990s, Sun said. “It started the idea that some of these hearts actually get better,” he said. “We don’t know why, but they do. ”
Sun said hearts seem to improve on pumps for about three months, but then begin to falter. He said it’s like a marathon runner who gets injured. It needs rest, but if it sits on the couch too long, it begins to regress.
“The next dialogue,” Sun said, “is who gets a transplant.”