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Background  Little is known about the hemodynamic response to exercise in heart failure patients at various ages before and after heart transplantation ( HT ). This information is important because postoperative hemodynamics may be a predictor of survival. To investigate the hemodynamic response to  HT  and exercise, we grouped our patients based on preoperative age and examined their hemodynamics at rest and during exercise before and after  HT .    Methods and Results  Ninety‐four patients were evaluated at rest prior to HT with right heart catheterization at our laboratory. Of these patients, 32 were evaluated during slight supine exercise before and 1 year after  HT . Postoperative evaluations were performed at rest 1 week after  HT  and at rest and during exercise at 4 weeks, 3 months, 6 months, and 1 year after  HT . The exercise patients were divided into 2 groups based on preoperative age of ≤50 or >50 years. There were no age‐dependent differences in the preoperative hemodynamic exercise responses. Hemodynamics markedly improved at rest and during exercise at 1 and 4 weeks, respectively, after  HT ; however, pulmonary and, in particular, ventricular filling pressures remained high during exercise at 1 year after  HT , resulting in normalized pulmonary vascular resistance response but deranged total pulmonary vascular resistance response.    Conclusions  Our findings suggest that, (1) in patients with heart failure age ≤50 or >50 years may not affect the hemodynamic response to exercise to the same extent as in healthy persons, and (2) total pulmonary vascular resistance may be more adequate than pulmonary vascular resistance for evaluating the exercise response after  HT .

Hemodynamic Characteristics Including Pulmonary Hypertension at Rest and During Exercise Before and After Heart Transplantation