One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation
Abstract 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...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-06-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13234 |
| _version_ | 1797976423863943168 |
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| author | Susanne E.A. Felix Martinus I.F. Oerlemans Faiz Z. Ramjankhan Steven A. Muller Hans H. Kirkels Linda W. vanLaake Willem J.L. Suyker Folkert W. Asselbergs Nicolaas deJonge |
| author_facet | Susanne E.A. Felix Martinus I.F. Oerlemans Faiz Z. Ramjankhan Steven A. Muller Hans H. Kirkels Linda W. vanLaake Willem J.L. Suyker Folkert W. Asselbergs Nicolaas deJonge |
| author_sort | Susanne E.A. Felix |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-11T04:51:51Z |
| format | Article |
| id | doaj.art-1c72d05de64b4e89904b828598c21a9b |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-11T04:51:51Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-1c72d05de64b4e89904b828598c21a9b2022-12-27T03:53:06ZengWileyESC Heart Failure2055-58222021-06-01831796180510.1002/ehf2.13234One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantationSusanne E.A. Felix0Martinus I.F. Oerlemans1Faiz Z. Ramjankhan2Steven A. Muller3Hans H. KirkelsLinda W. vanLaake4Willem J.L. Suyker5Folkert W. Asselbergs6Nicolaas deJonge7Department of Cardiology University Medical Center of Utrecht Heidelberglaan 100 Utrecht 3584 CX The NetherlandsDepartment of Cardiology University Medical Center of Utrecht Heidelberglaan 100 Utrecht 3584 CX The NetherlandsDepartment of Cardiothoracic Surgery University Medical Center of Utrecht Utrecht The NetherlandsDepartment of Cardiology University Medical Center of Utrecht Heidelberglaan 100 Utrecht 3584 CX The NetherlandsDepartment of Cardiology University Medical Center of Utrecht Heidelberglaan 100 Utrecht 3584 CX The NetherlandsDepartment of Cardiothoracic Surgery University Medical Center of Utrecht Utrecht The NetherlandsDepartment of Cardiology University Medical Center of Utrecht Heidelberglaan 100 Utrecht 3584 CX The NetherlandsDepartment of Cardiology University Medical Center of Utrecht Heidelberglaan 100 Utrecht 3584 CX The NetherlandsAbstract 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.https://doi.org/10.1002/ehf2.13234Mechanical circulatory supportQuality of lifeFunctional capacityCardiopulmonary exercise test. VO2 |
| spellingShingle | Susanne E.A. Felix Martinus I.F. Oerlemans Faiz Z. Ramjankhan Steven A. Muller Hans H. Kirkels Linda W. vanLaake Willem J.L. Suyker Folkert W. Asselbergs Nicolaas deJonge One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation ESC Heart Failure Mechanical circulatory support Quality of life Functional capacity Cardiopulmonary exercise test. VO2 |
| title | One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation |
| title_full | One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation |
| title_fullStr | One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation |
| title_full_unstemmed | One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation |
| title_short | One year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation |
| title_sort | one year improvement of exercise capacity in patients with mechanical circulatory support as bridge to transplantation |
| topic | Mechanical circulatory support Quality of life Functional capacity Cardiopulmonary exercise test. VO2 |
| url | https://doi.org/10.1002/ehf2.13234 |
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