The Role of Sphingolipids in Myocardial Recovery Mediated by Mechanical Unloading and Circulatory Support

Myocardial recovery after left ventricular assist device (LVAD) support is a critical phenomenon that allows advanced heart failure patients to retain their native heart. We quantified targeted sphingolipids in serum and cardiac tissue of patients who exhibited recovery post-LVAD. Our analysis revealed sustained elevated circulating ceramides levels in nonresponders post-LVAD, whereas responders showed reduced sphingosine-1-phosphate (S1P) levels. In contrast, cardiac tissue from nonresponders displayed increased S1P levels. We suggest that diminished ceramide and S1P may contribute to an increased likelihood of recovery after LVAD support. Collectively, our findings implicate the sphingolipid metabolic pathway as a potential therapeutic target to promote myocardial recovery after mechanical support.