Hospital Care in 2000s: Findings from A Large National Database

Abstract

Rationale: Heart failure with reduced ejection fraction (HFrEF) is usually characterized by low levels of VO2 peak. Optimal drug therapy, cardiac devices and physical rehabilitation can improve both left ventricle ejection fraction (EF) and levels of VO2 peak. We describe an unusual case of significant discrepancy between VO2 peak and EF dynamics in severe heart failure patient on optimal drug therapy, after long term cardiac device therapy (Optimizer Smart IVs) and physical rehabilitation.Patient Concern: In this report, a 58-year-old male with HFrEF after long term cardiac device therapy (Optimizer Smart IVs) and physical rehabilitation significantly improving VO2 peak. Diagnosis:The patient was diagnosed with coronary artery disease, repeated myocardial infarctions and HFrEF. Interventions:The patient underwent long term cardiac device therapy (Optimizer Smart IVs) and physical rehabilitation based on lactate threshold achievement during cardiopulmonary exercising test. Outcomes:The patient had significant improvement in VO2 peak level, but EF did not change. Conclusion:The difference between VO2peak and EF dynamics may be a result of skeletal muscles oxygen uptake improvement after aerobic physical rehabilitation.