The CORolla device for energy transfer from systole to diastole: a novel treatment for heart failure with preserved ejection fraction.

It is estimated that 30 to 50% of heart failure patients have heart failure with preserved ejection fraction (HFpEF). Mortality is high in this patient population, and morbidity and rate of hospitalization are similar to those of heart failure patients with reduced ejection fraction (HFrEF). The management of patients with HFpEF is essentially empirical, limited, and disappointing. HFpEF is characterized by diastolic dysfunction leading to increased left ventricular (LV) filling pressures. We have previously described how mechanical energy transfer from the systole phase to the diastole phase of the cardiac cycle can potentially reduce filling pressures during the diastolic phase which may improve clinical symptoms of HFpEF. The CORolla device is a novel device anatomically designed for positioning in the left ventricle (LV) and mechanically designed to apply an outward radial force on the LV endocardium thus transferring energy from the systolic phase, in which the device contracts, gaining potential energy, to the diastolic phase from its recoil. Here we summarize the present knowledge concerning the energy transfer therapeutic approach for HFpEF, describe the CORolla device, and depict its potential future clinical indications.