ObjectiveTo investigate the factors influencing myocardial recovery after left ventricular assist device (LVAD) implantation, aiming to identify patient characteristics associated with a higher potential for cardiac recovery and to inform clinical decision-making. MethodsThis retrospective study included consecutive patients with end-stage heart failure who underwent LVAD implantation at our institution between 2021 and June, 2025. Patients were categorized into three groups including a myocardial recovery group, an ongoing LVAD support group, and death group. Based on their postoperative outcomes, demographic, laboratory, and imaging data were compared among the groups. Multivariate logistic regression analysis was performed to identify independent predictors of myocardial recovery. Results A total of 57 patients who received an LVAD were included. Among them, 9 (15.8%) achieved myocardial recovery, 39 (68.4%) remained on LVAD support, and 9 (15.8%) died. Multivariate analysis identified younger age (OR=0.875, P=0.004) and a smaller preoperative left ventricular end-systolic diameter (LVESD) (OR=0.866, P=0.047) as independent predictors of myocardial recovery. Notably, all patients in the recovery group were male and had no prior implantation of an implantable cardioverter-defibrillator/cardiac resynchronization therapy defibrillator. Furthermore, a higher preoperative prealbumin level was significantly associated with survival (OR=1.018, P=0.024). ConclusionYounger age and a smaller preoperative LVESD are key predictors for myocardial recovery following LVAD implantation. Younger patients with a smaller LVESD exhibit a greater potential for functional recovery. Preoperative nutritional status, as indicated by prealbumin levels, may be a predictor of mortality.
