Assessing exercise performance after heart transplantation

Ulubay, Gaye; Ulaşlı, Sevinç Sarınç; Sezgin, Atilla; Haberal, Mehmet

doi:10.1111/j.1399-0012.2007.00658.x

Cited by 17 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results showed that exercise decreases the burden of depression and anxiety, with HIT showing significant positive effects compared with usual care[ 79 ]. Additionally, the results align with the correlation between higher physical capacity and less depression and anxiety rates[ 25 , 83 , 84 ].…”

Section: Introductionsupporting

confidence: 78%

Importance of physical capacity and the effects of exercise in heart transplant recipients

Yardley¹,

Gullestad²,

Nytrøen³

2018

WJT

View full text Add to dashboard Cite

One of the most important prognostic factors in heart failure patients is physical capacity. Patients with very poor physical performance and otherwise eligible, may be listed as candidates for heart transplantation (HTx). After such surgery, life-long immunosuppression therapy is needed to prevent rejection of the new heart. The dark side of immunosuppression is the increased risk of infections, kidney failure, cancer and advanced atherosclerosis (cardiac allograft vasculopathy), with the two latter conditions as the main causes of later mortality. In a worldwide perspective, 50% of the HTx patients survive past 10 years. Poor aerobic capacity prior to graft deterioration is not only limited to the failing heart, but also caused by peripheral factors, such as limited function in the skeletal muscles and in the blood vessels walls. Exercise rehabilitation after HTx is of major importance in order to improve physical capacity and prognosis. Effects of high-intensity interval training (HIT) in HTx recipients is a growing field of research attracting worldwide focus and interest. Accumulating evidence has shown that HIT is safe and efficient in maintenance HTx recipients; with superior effects on physical capacity compared to conventional moderate exercise. This article generates further evidence to the field by summarizing results from a decade of research performed at our center supported by a broad, but not strict formal, literature review. In short, this article demonstrates a strong association between physical capacity measured after HTx and long-term survival. It describes the possible “HIT-effect” with increased levels of inflammatory mediators of angiogenesis. It also describes long-term effects of HIT; showing a positive effect in development of anxiety symptoms despite that the improved physical capacity was not sustained, due to downregulation of exercise and intensity. Finally, our results are linked to the ongoing HITTS study, which investigates safety and efficiency of HIT in de novo HTx recipients. Together with previous results, this study may have the potential to change existing guidelines and contribute to a better prognosis for the HTx population as a whole.

show abstract

Section: Introductionsupporting

confidence: 78%

Importance of physical capacity and the effects of exercise in heart transplant recipients

Yardley¹,

Gullestad²,

Nytrøen³

2018

WJT

View full text Add to dashboard Cite

show abstract

“…Maintenance HTx recipients tend to score lower than the general population on the physical function domains of HRQoL [ 7 , 8 ]. Interventions to improve physical function in HTx recipients are of special interest since improved physical function is associated with better HRQoL [ 11 , 17 ] and is a strong predictor for survival [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

High-intensity interval training and health-related quality of life in de novo heart transplant recipients – results from a randomized controlled trial

Rolid

Andreassen

Yardley

et al. 2020

Health Qual Life Outcomes

View full text Add to dashboard Cite

Background Studies on the effect of high-intensity interval training (HIT) compared with moderate intensity continuous training (MICT) on health-related quality of life (HRQoL) after heart transplantation (HTx) is scarce. No available studies among de novo HTx recipients exists. This study aimed to investigate the effect of HIT vs. MICT on HRQoL in de novo recipients. Methods The HITTS study randomized eighty-one de novo HTx recipients to receive either HIT or MICT (1:1). The HIT intervention were performed with 2–4 interval bouts with an intensity of 85–95% of maximal effort. The MICT group exercised at an intensity of 60–80% of their maximal effort with a duration of 25 min. HRQoL was assessed by the Short Form-36 version 2 (SF-36v2) and the Hospital Anxiety and Depression Scale, mean 11 weeks after surgery and after a nine months’ intervention. The participants recorded their subjective effect of the interventions on their general health and well-being on a numeric visual analogue scale. Clinical examinations and physical tests were performed. Differences between groups were investigated with independent Student t-tests and with Mann-Whitney U tests where appropriate. Within-group differences were analyzed with Paired-Sample t-tests and Wilcoxon Signed Rank tests. Correlations between SF-36 scores and VO 2peak were examined with Pearson’s correlations. Results Seventy-eight participants completed the intervention. Both exercise modes were associated with improved exercise capacity on the physical function scores of HRQoL. Mental health scores remained unchanged. No differences in the change in HRQoL between the groups occurred except for Role Emotional subscale with a larger increase in the HIT arm. Better self-reported physical function was associated with higher VO 2peak and muscle strength. Conclusion HIT and MICT resulted in similar mean changes in HRQoL the first year after HTx. Both groups experienced significant improvements in the physical SF-36v2. Trial registration ClinicalTrials.gov number: NCT01796379 Registered 18 February 2013.

show abstract

“…Согласно мировым данным, исходно низкая ФР пациентов с ХСН в динамике после ТС улучшается, выполнение ФА также способствует более высо-ким результатам ФР [21,22]. По нашим результа-там, к 1 году после ТС была достигнута нормали-зация ФР.…”

Section: Discussionunclassified

The Experience of Pediatric Heart Transplantation on North-West of Russian Federation

Simonenko

Первунина

Федотов

et al. 2018

RJTAO

View full text Add to dashboard Cite

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России, Санкт-Петербург, Российская Федерация Цель. Оценить ранние и отдаленные результаты трансплантаций сердца (ТС) у пациентов до 18 лет, выполненных в ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России. Материалы и методы. С ап-реля 2011-го по сентябрь 2017 г. выполнено 5 ортотопических ТС реципиентам (все женского пола) от взрослых доноров. Медиана возраста составила 15 лет (10-16), фракция выброса левого желудочка до ТС -17% (10-33%). Причинами развития хронической сердечной недостаточности были в двух случаях дилатационная кардиомиопатия и по одному случаю -некомпактного миокарда, аритмогенной диспла-зии правого желудочка и аномалии Эбштейна. Длительность нахождения в листе ожидания ТС -76 дней (12-684). Одной пациентке в качестве «моста к ТС» была имплантирована бивентрикулярная система экстракорпоральной механической поддержки кровообращения Berlin Heart EXCOR (250 суток). По ре-зультатам коронароангиографии только в одном случае было выявлено атеросклеротическое поражение сосудов у донора, в связи с чем ТС была выполнена одновременно с аортокоронарным шунтированием. Все реципиенты получали стандартную иммуносупрессивную терапию такролимусом, препаратами микофеноловой кислоты, глюкокортикостероидами. Индукция была выполнена у четырех пациентов антитимоцитарным глобулином, у одного -базиликсимабом. Проведена ретроспективная оценка лабо-раторно-инструментальных исследований и частоты развития осложнений в посттрансплантационном периоде. Результаты. Медиана времени наблюдения после ТС составила 35,9 месяца (4,4-73,7). Пациенты находились в отделении реанимации 12 суток (4-18), а одна пациентка -18 суток, в связи с развитием синдрома обратимой лейкоэнцефалопатии (PRES), что потребовало замены такролимуса на циклоспорин. Инотропная поддержка в послеоперационном периоде проводилась в течение 3 суток (3-8). Через один год после ТС показатели ЭхоКГ были в норме. По результатам кардиореспираторного теста к одному году после ТС пиковое потребление кислорода (VO 2peak ) достигло нормальных значений. По результатам ЭМБ (n = 48) клинических проявлений отторжения не было, острый криз клеточного отторжения (R2) был диагностирован в 12,5% случаев. В отдаленном периоде значимых осложнений не наблюдалось. Выводы. Выполнение ТС является эффективным методом лечения терминальной ХСН в детском возрас-те. Кризов отторжения с дисфункцией трансплантата на фоне комбинированной иммуносупрессивной терапии не было. У всех пациентов произошло полное восстановление трудоспособности, возобновлена образовательная деятельность.Ключевые слова: трансплантация сердца, трансплантация сердца у детей, хроническая сердечная недостаточность, отторжение, болезнь коронарных сосудов пересаженного сердца, физическая работоспособность.

show abstract

Assessing exercise performance after heart transplantation

Abstract: In the long-term treatment of heart transplant recipients, exercise training should be considered an important therapeutic tool that enables patients to achieve a good quality of life.

Cited by 17 publications

References 29 publications

Importance of physical capacity and the effects of exercise in heart transplant recipients

Importance of physical capacity and the effects of exercise in heart transplant recipients

High-intensity interval training and health-related quality of life in de novo heart transplant recipients – results from a randomized controlled trial

The Experience of Pediatric Heart Transplantation on North-West of Russian Federation

Contact Info

Product

Resources

About