{
  "abstract": "Background\n\nMyocardial recovery sufficient for left ventricular assist device (LVAD) explantation remains uncommon. Titin truncating variant (TTNtv)-associated cardiomyopathy demonstrates favorable reverse remodeling with medical therapy, but its remodeling potential during durable mechanical unloading is unknown.Methods\n\nWe conducted a retrospective, single-center study of adults undergoing HeartMate 3 LVAD implantation from 2016-2025. Patients were categorized as TTNtv-associated cardiomyopathy, other genetically characterized nonischemic cardiomyopathy (NICM), or ischemic cardiomyopathy (ICM). The primary endpoint was absolute change in left ventricular end-systolic volume index (LVESVI) during LVAD support. Multivariable and sensitivity analyses evaluated potential confounding and influential observations.Results\n\nAmong 51 patients, 7 had TTNtv-associated cardiomyopathy, 9 other NICM, and 35 ICM. TTNtv patients were younger than other NICM and ICM patients (40.5±15.8 vs 45.8±11.0 vs 67.4±9.3 years; P<0.001). Mean LVESVI decreased by 87.7±71.8 mL/m² in TTNtv patients compared with 30.4±28.3 mL/m² in other NICM and 32.6±30.6 mL/m² in ICM (P=0.039). Compared with ICM, TTNtv status remained associated with greater LVESVI reduction after adjustment for baseline LV end-diastolic diameter (β=-47.2 mL/m²; 95% CI, -75.9 to -18.4; P=0.002). Findings were directionally consistent across sensitivity analyses addressing age, post-LVAD guideline-directed medical therapy, follow-up duration, cardiomyopathy substrate, and influential observations. TTNtv patients more frequently met volumetric reverse remodeling criteria (85.7% vs 22.2% vs 57.1%; P=0.044).Conclusions\n\nTTNtv-associated cardiomyopathy was associated with greater structural reverse remodeling during LVAD support, particularly LVESVI reduction. Although limited by the small TTNtv cohort and potential residual confounding, these hypothesis-generating findings suggest that genetic substrate may contribute to myocardial remodeling during mechanical unloading.",
  "abstract_shown": true,
  "affiliations": [
    "Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Donald Richards"
    },
    {
      "affs": [
        0
      ],
      "name": "Robert M Cole"
    },
    {
      "affs": [
        0
      ],
      "name": "Michelle Kittleson"
    },
    {
      "affs": [
        0
      ],
      "name": "Daniel Mitchell"
    },
    {
      "affs": [
        0
      ],
      "name": "Vahid Yazdi"
    },
    {
      "affs": [
        0
      ],
      "name": "Meshe Chonde"
    },
    {
      "affs": [
        0
      ],
      "name": "Laura DiChiacchio"
    },
    {
      "affs": [
        0
      ],
      "name": "Lawrence Czer"
    },
    {
      "affs": [
        0
      ],
      "name": "Jaime Moriguchi"
    },
    {
      "affs": [
        0
      ],
      "name": "Jon Kobashigawa"
    },
    {
      "affs": [
        0
      ],
      "name": "Evan P Kransdorf"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3rh1g2e714zyz.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jhlto.2026.100688",
  "fulltext_url": "https://europepmc.org/articles/PMC13694927",
  "id": "3rh1g2e714zyz",
  "issns": [
    "2950-1334"
  ],
  "landing_url": "https://europepmc.org/article/MED/42927226",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2204|Mechanical Circulatory Support Devices"
    ]
  ],
  "openalex": "W7213916667",
  "pdf_url": "https://europepmc.org/articles/PMC13694927?pdf=render",
  "pmcid": "PMC13694927",
  "pmid": "42927226",
  "published": "2026-09-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3rh1g2e714zyz.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42927226",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42927226"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Transplantation: Methods and Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Enhanced structural reverse remodeling following LVAD support in patients with TTN truncating variants.",
  "title_text": "Enhanced structural reverse remodeling following LVAD support in patients with TTN truncating variants.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/3rh1g2e714zyz",
  "venue": "JHLT open",
  "versions": []
}