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Changes in exercise capacity, ventilation, and body weight following heart transplantation
Author(s) -
Habedank Dirk,
Ewert Ralf,
Hummel Manfred,
Wensel Roland,
Hetzer Roland,
Anker Stefan D.
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2006.07.001
Subject(s) - medicine , heart failure , cardiology , confounding , heart transplantation , ventilation (architecture) , vo2 max , confidence interval , heart rate , blood pressure , mechanical engineering , engineering
Aims: Peak oxygen uptake adjusted to body weight (peak VO 2 ) and ventilatory efficiency (VE/VCO 2 ‐slope) are important prognostic parameters in chronic heart failure. Our study prospectively examined changes in these parameters over 24months following heart transplantation (HTx) and evaluated the potentially confounding effects of weight gain. Methods and results: One hundred patients with chronic heart failure (16 female, mean age at HTx 53.9±9.6years) underwent cardiopulmonary exercise testing before and 3, 6, 12 and/or 24months after HTx. Twenty‐five healthy individuals served as matched normals. VE/VCO 2 ‐slope during exercise improved significantly at 6 (−23.7%), 12 (−21.3%), and 24months (−32.3%; all p <0.002 vs. baseline). At 6months, VE/VCO 2 ‐slopes were similar to the matched normals (31.8±4.3), 46 of 78 patients achieved values within the 95% confidence interval of normal. Peak VO 2 increased significantly after HTx at 6 (+31.8%), 12 (+36.2%), and 24months (+42.2%; all p <0.005). None of the patients reached values within the 95% CI of normal. Although VE/VCO 2 ‐slope and peak VO 2 were correlated inversely at every time point ( p <0.03), reduction in VE/VCO 2 ‐slope did not correlate with increase in peak VO 2 . Symptoms that limited exercise changed from dyspnoea before HTx to leg fatigue after HTx. Conclusion: Following HTX, VE/VCO 2 ‐slope returns to normal values in the majority of patients; however, despite improvement, peak VO 2 remains abnormal in all patients. Symptoms causing patients to stop exercising change from dyspnoea to leg fatigue.