Changes in exercise capacity induced by heart transplantation: prognostic and therapeutic implications.

Abstract:

: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 (VO(2) ) (odds ratio 0.69, P=0.017) independently predicted peak VO(2) improvement after HT. In the post-HT phase, body mass index (BMI) [adjusted hazard ratio (HR) 1.16, P=0.034] and VE (ventilation)/VCO(2) (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 VO(2) 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 VE/VCO(2) 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.

journal_name

Scand J Med Sci Sports

authors

Grigioni F,Specchia S,Maietta P,Potena L,Bacchi-Reggiani ML,Ghetti G,Boriani G,Foschi E,Corazza I,Ionico T,Magnani G,Zannoli R,Tentoni C,Branzi A

doi

10.1111/j.1600-0838.2009.01065.x

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

519-25

issue

4

eissn

0905-7188

issn

1600-0838

pii

SMS1065

journal_volume

21

pub_type

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