Evaluation of native left ventricular function during mechanical circulatory support: theoretical basis and clinical limitations.

Left ventricular function on patients with heart disease is now evaluated by echocardiography, but these dimensional changes are erroneous in the patient supported by left ventricular assist device because of mechanical unloading for the failing heart. Left ventricular end-systolic pressure-volume relationship provides theoretically most reliable left ventricular contractility. Recently, some patients have weaned from the device because of unexpected recovery of myocardial contractility. But it is very important to evaluate the left ventricular function just before the weaning, and to predict the longevity of the recovered function to keep the good quality of life. Current clinical situation in the patients with ventricular assist device, and theoretical limitations to evaluate the recovering myocardium are discussed.