Document Detail


Changes in exercise capacity induced by heart transplantation: prognostic and therapeutic implications.
MedLine Citation:
PMID:  20459480     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Survival and exercise performance are key targets of heart transplantation (HT). We designed this study to help in identifying (1) patients with chronic heart failure (CHF) at risk of poor exercise capacity after HT and (2) HT recipients presenting risk factors modifiable with exercise showing a potential impact on outcome. We enrolled 49 HT recipients (age 52 ± 12 years, 84% males) who underwent a cardiopulmonary exercise test before (9 ± 6 months) and after (20 ± 14 months) HT. In the CHF phase, lower peak oxygen consumption (V̇O(2) ) (odds ratio 0.69, P=0.017) independently predicted peak V̇O(2) improvement after HT. In the post-HT phase, body mass index (BMI) [adjusted hazard ratio (HR) 1.16, P=0.034] and V̇E (ventilation)/V̇CO(2) (carbon dioxide production) slope (adjusted HR 1.07, P=0.031) independently predicted mortality. In conclusion, CHF patients with only a moderate impairment of peak V̇O(2) are at a risk of failing to achieve a significant improvement of exercise performance after HT. In the post-HT phase, a BMI≥28 and/or a V̇E/V̇CO(2) slope ≥47 represent risk factors for death, which are potentially modifiable with exercise. Prospective randomized studies are needed to analyze the effects of training on functional capacity and outcome in the different subsets of HT recipients.
Authors:
F Grigioni; S Specchia; P Maietta; L Potena; M L Bacchi-Reggiani; G Ghetti; G Boriani; E Foschi; I Corazza; T Ionico; G Magnani; R Zannoli; C Tentoni; A Branzi
Publication Detail:
Type:  Journal Article     Date:  2010-03-10
Journal Detail:
Title:  Scandinavian journal of medicine & science in sports     Volume:  21     ISSN:  1600-0838     ISO Abbreviation:  Scand J Med Sci Sports     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111504     Medline TA:  Scand J Med Sci Sports     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  519-25     Citation Subset:  IM    
Copyright Information:
© 2010 John Wiley & Sons A/S.
Affiliation:
Department of Cardiovascular Diseases, School of Medicine, University of Bologna, Bologna, Italy Department of Histology, Embryology and Applied Biology, School of Exercise and Sport Sciences, University of Bologna, Bologna, Italy Department of Cardiovascular Diseases, School of Physics, University of Bologna, Bologna, Italy.
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