Changes in exercise capacity induced by heart transplantation: Prognostic and therapeutic implications
Scandinavian Journal of Medicine and Science in Sports, ISSN: 0905-7188, Vol: 21, Issue: 4, Page: 519-525
2011
- 7Citations
- 69Captures
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Metrics Details
- Citations7
- Citation Indexes7
- CrossRef7
- Captures69
- Readers69
- 69
Article Description
Survival and exercise performance are key targets of heart transplantation (HT). We designed this study to help in identifying (1) patients with chronic heart failure (CHF) at risk of poor exercise capacity after HT and (2) HT recipients presenting risk factors modifiable with exercise showing a potential impact on outcome. We enrolled 49 HT recipients (age 52 ± 12 years, 84% males) who underwent a cardiopulmonary exercise test before (9 ± 6 months) and after (20 ± 14 months) HT. In the CHF phase, lower peak oxygen consumption (V̇O ) (odds ratio 0.69, P=0.017) independently predicted peak V̇O improvement after HT. In the post-HT phase, body mass index (BMI) [adjusted hazard ratio (HR) 1.16, P=0.034] and V̇E (ventilation)/V̇CO (carbon dioxide production) slope (adjusted HR 1.07, P=0.031) independently predicted mortality. In conclusion, CHF patients with only a moderate impairment of peak V̇O are at a risk of failing to achieve a significant improvement of exercise performance after HT. In the post-HT phase, a BMI≥28 and/or a V̇E/V̇CO slope ≥47 represent risk factors for death, which are potentially modifiable with exercise. Prospective randomized studies are needed to analyze the effects of training on functional capacity and outcome in the different subsets of HT recipients. © 2010 John Wiley & Sons A/S.
Bibliographic Details
Wiley
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