One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation
Autor: | Linda W. van Laake, Folkert W. Asselbergs, Willem J.L. Suyker, Faiz Ramjankhan, Susanne E.A. Felix, Hans Kirkels, Martinus I. F. J. Oerlemans, Steven A Muller, Nicolaas de Jonge |
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Přispěvatelé: | Cardiology |
Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty Cardiopulmonary exercise test. VO2 Hemodynamics 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Quality of life Mechanical circulatory support Original Research Articles Internal medicine Functional capacity Heart rate Diseases of the circulatory (Cardiovascular) system Humans Medicine In patient Original Research Article 030212 general & internal medicine Retrospective Studies Exercise Tolerance business.industry Exercise capacity medicine.disease Tissue Donors humanities RC666-701 Heart failure Circulatory system Quality of Life Cardiology Heart Transplantation Female Bridge to transplantation Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
Zdroj: | ESC heart failure, 8(3), 1796-1805. The Heart Failure Association of the European Society of Cardiology ESC Heart Failure, Vol 8, Iss 3, Pp 1796-1805 (2021) ESC Heart Failure |
ISSN: | 2055-5822 |
Popis: | 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. |
Databáze: | OpenAIRE |
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