Interval training does not modulate diastolic function in heart transplant recipients

Monk-Hansen, Tea; Dall, Christian Have; Christensen, Stefan; Snoer, Martin; Gustafsson, Finn; Rasmusen, Hanne Kruuse; Prescott, Eva

doi:10.3109/14017431.2013.871058

Cited by 16 publications

(17 citation statements)

References 26 publications

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“…This was also the conclusion in a recent study of predictors of VO 2peak in HTx recipients . Further, we have recently shown that echocardiographic parameters during rest or during exercise are not affected by exercise training, despite considerable effect on VO 2peak , confirming that the effects of exercise are primarily peripheral and not through cardiac remodeling.…”

Section: Discussionsupporting

confidence: 87%

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Effect of High-Intensity Training Versus Moderate Training on Peak Oxygen Uptake and Chronotropic Response in Heart Transplant Recipients: A Randomized Crossover Trial

Dall

Snoer

Christensen

et al. 2014

American Journal of Transplantation

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In heart transplant (HTx) recipients, there has been reluctance to recommend high-intensity interval training (HIIT) due to denervation and chronotropic impairment of the heart. We compared the effects of 12 weeks' HIIT versus continued moderate exercise (CON) on exercise capacity and chronotropic response in stable HTx recipients >12 months after transplantation in a randomized crossover trial. The study was completed by 16 HTx recipients (mean age 52 years, 75% males). Baseline peak oxygen uptake (VO 2peak ) was 22.9 mL/kg/min. HIIT increased VO 2peak by 4.9 AE 2.7 mL/min/kg (17%) and CON by 2.6 AE 2.2 mL/ kg/min (10%) (significantly higher in HIIT; p < 0.001). During HIIT, systolic blood pressure decreased significantly (p ¼ 0.037) with no significant change in CON (p ¼ 0.241; between group difference p ¼ 0.027). Peak heart rate (HR peak ) increased significantly by 4.3 beats per minute (p ¼ 0.014) after HIIT with no significant change in CON (p ¼ 0.34; between group difference p ¼ 0.027). Heart rate recovery (HR recovery ) improved in both groups with a trend toward greater improvement after HIIT. The 5-month washout showed a significant loss of improvement. HIIT was well tolerated, had a superior effect on oxygen uptake, and led to an unexpected increase in HR peak accompanied by a faster HR recovery . This indicates that the benefits of HIIT are partly a result of improved chronotropic response.Abbreviations: absolute VO 2peak , peak oxygen uptake (mL/min); bpm, beats per minute; CON, continued moderate exercise; DBP, diastolic blood pressure; HIIT, high-intensity interval training; HR, heart rate; HR peak , peak heart rate; HR recovery , heart rate recovery; HR reserve , heart rate reserve; HR rest , resting heart rate; HTx, heart transplant; RER, respiratory exchange ratio; SBP, systolic blood pressure; SET, strength and endurance training; VO 2peak , peak oxygen uptake (mL/min/kg)

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Section: Discussionsupporting

confidence: 87%

“…Studies on HTx recipients participating in exercise rehabilitation suggest both central and peripheral adaptations to explain the improved exercise capacity . Currently, the physiological mechanisms are not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Effect of High-Intensity Training Versus Moderate Training on Peak Oxygen Uptake and Chronotropic Response in Heart Transplant Recipients: A Randomized Crossover Trial

Dall

Snoer

Christensen

et al. 2014

American Journal of Transplantation

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“…Among the 13 included trials, 6 had an unclear risk of selection bias, [15][16][17][18][19][20] 1 had a high risk of selection bias, 21 and 7 failed to describe concealed random allocation. 17,[19][20][21][22][23][24] In addition, 1 trial had an unclear risk of attrition bias, 19 and 1 trial had a high risk of reporting bias.…”

Section: Methodological Qualitymentioning

confidence: 99%

Meta-Analysis of the Effects of Exercise Training on Markers of Metabolic Syndrome in Solid Organ Transplant Recipients

et al. 2018

Prog Transpl

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“…Exercise capacity is generally limited to approximately 50-70% of the age-predicted value in HTX patients despite normal LV ejection fraction (LVEF) and independent of the presence of cardiac allograft vasculopathy (CAV) [10][11][12][13][14][15]. It has been speculated that the reduction in exercise capacity observed in HTX patients may be caused by elevated LV-FP [7,16,17].…”

Section: Introductionmentioning

confidence: 99%

Clinical features, exercise hemodynamics, and determinants of left ventricular elevated filling pressure in heart-transplanted patients

et al. 2015

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SummaryThis study aimed to assess clinical, functional, and hemodynamic characteristics of heart-transplanted (HTX) patients during exercise. We performed comprehensive echocardiographic graft function assessment during invasive hemodynamic semi-supine exercise test in 57 HTX patients. According to hemodynamics findings, patients were divided into Group A: normal left ventricular (LV) filling pressure (FP): pulmonary capillary wedge pressure (PCWP) <15 mmHg at rest and <25 mmHg at peak exercise, and Group B: elevated LV-FP: PCWP ≥15 mmHg at rest or ≥25 mmHg at peak exercise. Thirty-one patients (54%) had normal LV-FP and 26 patients (46%) had elevated LV-FP. The latter had higher cumulative rejection burden (P < 0.01) and were more symptomatic (NYHA class >1) (P < 0.05), and cardiac allograft vasculopathy (CAV) was more prevalent (P < 0.05). With exercise, the changes in both left-and right-sided filling pressures were significantly increased, whereas LV longitudinal myocardial deformation was lower (P < 0.05) in patients with elevated LV-FP than in patients with normal LV-FP. No between-group difference was observed for cardiac index or LV ejection fraction (LVEF) during exercise. In conclusion, elevated LV-FP can be demonstrated in approximately 50% of HTX patients. Patients with elevated LV-FP have impaired myocardial deformation capacity, higher prevalence of CAV, and higher rejection burden, and were more symptomatic. Exercise test with the assessment of longitudinal myocardial deformation should be considered in routine surveillance of HTX patients as a marker of restrictive filling (ClinicalTrials.gov Identifier: NCT02077764).

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Interval training does not modulate diastolic function in heart transplant recipients

Abstract: The study does not support a role of diastolic dysfunction in the limited exercise capacity of HTx recipients and suggests that in these patients peripheral factors are of greater importance.

Cited by 16 publications

References 26 publications

Effect of High-Intensity Training Versus Moderate Training on Peak Oxygen Uptake and Chronotropic Response in Heart Transplant Recipients: A Randomized Crossover Trial

Effect of High-Intensity Training Versus Moderate Training on Peak Oxygen Uptake and Chronotropic Response in Heart Transplant Recipients: A Randomized Crossover Trial

Meta-Analysis of the Effects of Exercise Training on Markers of Metabolic Syndrome in Solid Organ Transplant Recipients

Clinical features, exercise hemodynamics, and determinants of left ventricular elevated filling pressure in heart-transplanted patients

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