Predictors of exercise capacity and the impact of angiographic coronary artery disease in heart transplant recipients

Gullestad, Lars; Myers, J.; Edvardsen, Thor; Kjekshus, J.; Geiran, Odd; Simonsen, Svein

doi:10.1016/j.accreview.2004.03.043

Cited by 5 publications

(8 citation statements)

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“…Exercise intolerance has a multifocal origin and involves complex interactions among cardiac, neurohormonal, psychologic, vascular, skeletal muscle, and pulmonary abnormalities in heart transplant recipients (12). Several studies have revealed the clinical problems that develop during the postoperative period in these patients (4, 5, 13, 14). Our study was performed to assess the factors that affect exercise performance by means of the SF‐36, the Beck Depression Inventory, and the results of exercise testing during the postoperative period in heart transplantation recipients (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…The main goal of therapy is to enable heart transplant recipients to return to a functional lifestyle with a good long‐term quality of life (1–3). Reduced exercise tolerance in heart recipients can result from deconditioning, graft rejection, cardiac denervation, or treatment with high‐dose immunosuppressive therapy (4, 5). However, no clinical research adequately explains the factors affecting exercise performance in heart transplantation recipients during the postoperative period.…”

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confidence: 99%

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Assessing exercise performance after heart transplantation

Ulubay¹,

Ulaşlı²,

Sezgin³

et al. 2007

Clinical Transplantation

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Assessing exercise performance after heart transplantation

Ulubay¹,

Ulaşlı²,

Sezgin³

et al. 2007

Clinical Transplantation

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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). It has been speculated that the reduction in exercise capacity observed in HTX patients may be caused by elevated LV‐FP .…”

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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“…indicated that peripheral limitations are major compared with central limitations in exercise capacity after heart transplantation. Many factors contribute to the decrease in exercise capacity after heart transplantation, including heart rate response to exercise, male gender, age, pulmonary vascular resistance, maximal systolic blood pressure and BMI (Gullestad et al. 2004, Käser et al.…”

Section: Discussionmentioning

confidence: 99%