One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation.

Autor: Felix SEA; Department of Cardiology, University Medical Center of Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands., Oerlemans MIF; Department of Cardiology, University Medical Center of Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands., Ramjankhan FZ; Department of Cardiothoracic Surgery, University Medical Center of Utrecht, Utrecht, The Netherlands., Muller SA; Department of Cardiology, University Medical Center of Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands., Kirkels HH, van Laake LW; Department of Cardiology, University Medical Center of Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands., Suyker WJL; Department of Cardiothoracic Surgery, University Medical Center of Utrecht, Utrecht, The Netherlands., Asselbergs FW; Department of Cardiology, University Medical Center of Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.; Institute of Health Informatics and Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK., de Jonge N; Department of Cardiology, University Medical Center of Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
Jazyk: angličtina
Zdroj: ESC heart failure [ESC Heart Fail] 2021 Jun; Vol. 8 (3), pp. 1796-1805. Date of Electronic Publication: 2021 Mar 12.
DOI: 10.1002/ehf2.13234
Abstrakt: Aims: Mechanical circulatory support (MCS) results in substantial improvement of prognosis and functional capacity. Currently, duration of MCS as a bridge to transplantation (BTT) is often prolonged due to shortage of donor hearts. Because long-term results of exercise capacity after MCS are largely unknown, we studied serial cardiopulmonary exercise tests (CPETs) during the first year after MCS implantation.
Methods and Results: Cardiopulmonary exercise tests at 6 and 12 months after MCS implantation in BTT patients were retrospectively analysed, including clinical factors related to exercise capacity. A total of 105 MCS patients (67% male, 50 ± 12 years) underwent serial CPET at 6 and 12 months after implantation. Power (105 ± 35 to 114 ± 40 W; P ≤ 0.001) and peak VO2 per kilogram (pVO2/kg) improved significantly (16.5 ± 5.0 to 17.2 ± 5.5 mL/kg/min (P = 0.008)). Improvement in pVO2 between 6 and 12 months after LVAD implantation was not related to heart failure aetiology or haemodynamic severity prior to MCS. We identified maximal heart rate at exercise as an important factor for pVO2. Younger age and lower BMI were related to further improvement. At 12 months, 25 (24%) patients had a normal exercise capacity (Weber classification A, pVO2 > 20 mL/kg/min).
Conclusions: Exercise capacity (power and pVO2) increased significantly between 6 and 12 months after MCS independent of Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile or heart failure aetiology. Heart rate at exercise importantly relates to exercise capacity. This long-term improvement in exercise capacity is important information for the growing group of long-term MCS patients as this is critical for the quality of life of patients.
(© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Databáze: MEDLINE
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