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Exercise capacity in an individual with LVAD explantation without heart transplantation.
MedLine Citation:
PMID:  20436356     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: Left ventricular assist devices (LVADs) have become a viable treatment alternative to heart transplantation, in some instances providing for a level of improvement of native heart function to allow for device explantation. The aim of this case study was to describe changes in physical work capacity following 9 months of LVAD support.
CLINICAL CASE: The patient described here was diagnosed with idiopathic dilated cardiomyopathy and demonstrated worsening heart failure over a 5-year period with a maximum left ventricular end-diastolic diameter of 8.99 cm and an ejection fraction of 15% to 25%. Upon implantation of an LVAD, central hemodynamic function improved and the device was removed after 9 months of support. Left ventricular diastolic and systolic diameter decreased by 39.8% and more than 30%, respectively. The left atrium decreased by 21.7% and ejection fraction was maintained by the LVAD and stabilized at 20%. Four months postexplantation, a cycle ergometry graded cardiopulmonary exercise test was performed. Exercise began at 0 W and increased 25 W per 3-minute stage.
RESULTS: The patient showed improvement in peak aerobic capacity when compared to pre-LVAD cardiopulmonary stress tests. Peak oxygen uptake increased from pre-LVAD measures of 11.8 mL x kg(-1) x min(-1) to 17.0 mL x kg(-1) x min(-1). Time to maximal exertion increased from 5 minutes 27 seconds to 15 minutes.
CONCLUSION: Results of this case study indicate that significant improvements in native heart function leading to an increased ability to perform work is possible following a period of mechanical unloading through LVAD support.
Authors:
Jeremy A Patterson; Ryan Z Amick; Hussam H Farhoud
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation and prevention     Volume:  30     ISSN:  1932-751X     ISO Abbreviation:  J Cardiopulm Rehabil Prev     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-07-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101291247     Medline TA:  J Cardiopulm Rehabil Prev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  231-4     Citation Subset:  IM    
Affiliation:
Department of Human Performance Studies, Wichita State University, Wichita, Kansas 67260, USA. jeremy.patterson@wichita.edu
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