Changes in Total Cardiac Output and Oxygen Extraction During Exercise in Patients Supported With an HVAD Left Ventricular Assist Device.

Abstract:

:Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO2 ). We investigated the changes in CO and avDO2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60.8 ± 7.3 years old, BMI 25.7 ± 3.3) underwent a six-minute walk test (6MWT), a cardiopulmonary exercise test (CPET), and noninvasive hemodynamic measurement. The mean six-minute walking distance (6MWD) was 403 m (68% of predicted), and mean peak VO2 was 10.9 mL/kg/min (39% of predicted). Mean total CO improved from 3.8 L at rest to 7.0 L at maximum exercise. The mean avDO2 increased from 7.4 mL/dL (44% of oxygen content) at rest to 13.2 mL/dL (75% of oxygen content) at maximum exercise. There was a significant increase in both total CO (P < 0.01) and avDO2 (P < 0.05) between rest and sub-maximum exercise. As exercise levels increased, however, no further significant changes were achieved. Long-term studies, especially in combination with exercise programs, would be desirable in order to observe the development of these parameters.

journal_name

Artif Organs

journal_title

Artificial organs

authors

Schmidt T,Bjarnason-Wehrens B,Mommertz S,Hannig M,Schulte-Eistrup S,Willemsen D,Reiss N

doi

10.1111/aor.13102

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

686-694

issue

7

eissn

0160-564X

issn

1525-1594

journal_volume

42

pub_type

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