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The RESTAGE-HF pharmacological regimen is an aggressive combination therapy developed by the University of Louisville for patients with advanced (Stage D) non-ischemic heart failure. Used in conjunction with mechanical unloading via a Left Ventricular Assist Device (LVAD), this protocol aims to induce myocardial recovery and heart failure remission. The regimen consists of standardized, high-dose titration of five existing medications: lisinopril (an ACE inhibitor), carvedilol (a beta-blocker), spironolactone (a mineralocorticoid receptor antagonist), losartan (an angiotensin receptor blocker), and digoxin (a cardiac glycoside). By targeting multiple neurohormonal pathways, the treatment promotes reverse structural remodeling of the failing heart, potentially allowing for the eventual removal of the LVAD in a significant proportion of patients.
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