History of The A-CURE Working Group
Investigations dating back to the 1960s have suggested that ventricular unloading (see “What is acute cardiac unloading”) before, during, or after the index ischemic event (heart attack) may positively affect cardiac function post-infarction.10-14 However, unloading the ventricle through either mechanical or medical means was clinically impractical. Therefore, interest in unloading was limited. However, with the development of percutaneous left ventricular support devices (pLVAD) in the early 2000’s interest in the therapeutic utility of acute ventricular unloading was invigorated.
In 2003, Meyns et al. published the first preclinical report demonstrating the effectiveness of unloading on myocardial infarct scar formation in the Journal of the American College of Cardiology.15 Over the proceeding decade, several laboratories from around the world began independent investigations into the utility of and molecular mechanisms underlying acute cardiac unloading. The developing collaborations and communication amongst these laboratories formed the foundation of the A-CURE Working Group. Since 2015 the group has convened on a biannual basis in private meetings to discuss the current efforts of the individual labs and gain insight and feedback from the member groups.
The 1st Annual A-CURE Public Symposium held in Rome, Italy, on August 26th, 2016. The A-CURE Public Symposium was attended by approximately 100 clinicians, scientists, and research professionals from 21 different countries. The meeting agenda featured keynote addresses by Dr. Eugene Braunwald (Founder of the TIMI Study Group, founding editor of Braunwald’s Heart Disease)16 and Dr. Joseph Hill (Editor-in-Chief of Circulation) The 2nd Annual A-CURE Public Symposium took place on August 24-25, 2017, in Barcelona, Spain. Dr. Valentin Fuster (Editor-in-Chief of JACC) joined as the Keynote Speaker. The 3rd Annual A-CURE Symposium is scheduled to take place on November 8-9, 2018, in Chicago, IL. This year’s Keynote Address will be given by Dr. Douglas Mann (Editor-in-Chief of JACC: Basic Transnational Research). The 2018 Symposium will be the first held in the United States, and will take place just prior to The American Heart Association Scientific Sessions.
- Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, Long JW, Ascheim DD, Tierney AR, Levitan RG, Watson JT, Meier P, Ronan NS, Shapiro PA, Lazar RM, Miller LW, Gupta L, Frazier OH, Desvigne-Nickens P, Oz MC, Poirier VL and Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Study G. Long-term use of a left ventricular assist device for end-stage heart failure. The New England journal of medicine. 2001;345:1435-43.
- Abraham WT, Adams KF, Fonarow GC, Costanzo MR, Berkowitz RL, LeJemtel TH, Cheng ML, Wynne J, Committee ASA, Investigators and Group AS. In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). Journal of the American College of Cardiology. 2005;46:57-64.
- Bayram M, De Luca L, Massie MB and Gheorghiade M. Reassessment of dobutamine, dopamine, and milrinone in the management of acute heart failure syndromes. The American journal of cardiology. 2005;96:47G-58G.
- Cuffe MS, Califf RM, Adams KF, Jr., Benza R, Bourge R, Colucci WS, Massie BM, O’Connor CM, Pina I, Quigg R, Silver MA, Gheorghiade M and Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure I. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. Jama. 2002;287:1541-7.
- Elkayam U, Tasissa G, Binanay C, Stevenson LW, Gheorghiade M, Warnica JW, Young JB, Rayburn BK, Rogers JG, DeMarco T and Leier CV. Use and impact of inotropes and vasodilator therapy in hospitalized patients with severe heart failure. American heart journal. 2007;153:98-104.
- Felker GM, Benza RL, Chandler AB, Leimberger JD, Cuffe MS, Califf RM, Gheorghiade M, O’Connor CM and Investigators O-C. Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study. Journal of the American College of Cardiology. 2003;41:997-1003.
- Follath F, Cleland JG, Just H, Papp JG, Scholz H, Peuhkurinen K, Harjola VP, Mitrovic V, Abdalla M, Sandell EP, Lehtonen L, Steering C and Investigators of the Levosimendan Infusion versus Dobutamine S. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet. 2002;360:196-202.
- Investigators AA, Armstrong PW, Granger CB, Adams PX, Hamm C, Holmes D, Jr., O’Neill WW, Todaro TG, Vahanian A and Van de Werf F. Pexelizumab for acute ST-elevation myocardial infarction in patients undergoing primary percutaneous coronary intervention: a randomized controlled trial. Jama. 2007;297:43-51.
- Mebazaa A, Nieminen MS, Packer M, Cohen-Solal A, Kleber FX, Pocock SJ, Thakkar R, Padley RJ, Poder P, Kivikko M and Investigators S. Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. Jama. 2007;297:1883-91.
- Levine HJ, McIntyre KM and Glovsky MM. Relief of angina pectoris by Valsalva maneuver. The New England journal of medicine. 1966;275:487-9.
- Laschinger JC, Grossi EA, Cunningham JN, Jr., Krieger KH, Baumann FG, Colvin SB and Spencer FC. Adjunctive left ventricular unloading during myocardial reperfusion plays a major role in minimizing myocardial infarct size. The Journal of thoracic and cardiovascular surgery. 1985;90:80-5.
- Van Winkle DM, Matsuki T, Gad NM, Jordan MC and Downey JM. Left ventricular unloading during reperfusion does not limit myocardial infarct size. Circulation. 1990;81:1374-9.
- Smalling RW, Cassidy DB, Barrett R, Lachterman B, Felli P and Amirian J. Improved regional myocardial blood flow, left ventricular unloading, and infarct salvage using an axial-flow, transvalvular left ventricular assist device. A comparison with intra-aortic balloon counterpulsation and reperfusion alone in a canine infarction model. Circulation. 1992;85:1152-9.
- Laks H, Ott RA, Standeven JW, Hahn JW, Blair OM and Willman VL. The effect of left atrial-to-aortic assistance on infarct size. Circulation. 1977;56:II38-43.
- Meyns B, Stolinski J, Leunens V, Verbeken E and Flameng W. Left ventricular support by catheter-mounted axial flow pump reduces infarct size. Journal of the American College of Cardiology. 2003;41:1087-95.
- Braunwald E, Mann, D.L., Bonow, R.O., Zipes, D.P., Libby, P. . Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine – 10th Edition. Philadelphia, PA: Elsevier Sauders; 2015.