Document Detail


Exercise limitation in trained heart and kidney transplant recipients: central and peripheral limitations.
MedLine Citation:
PMID:  16297781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To evaluate the role of central and peripheral contributions to exercise limitation after transplantation, we compared, during exercise, 2 groups of very well-trained heart transplants recipients (HTRs) and kidney transplant recipients (KTRs) with a group of control subjects (CSs), matched for physical level. METHODS: Nineteen male subjects, 7 HTRs, 6 KTRs and 6 CSs, participated in the study. All transplant patients were in sinus rhythm and were matched for immunosuppressive therapy, none of whom had therapy with chronotropic effects. Exercise capacities were evaluated using a symptom-limited treadmill test. Oxygen consumption (VO2) and heart rate (HR) were measured continuously. Heart rate reserve (HRR) was defined as peak HR minus resting HR; resting HR was the stabilized HR measured in the supine position before the treadmill test. RESULTS: Functional capacities were evaluated for all HTRs, KTRs and CSs, according to maximal VO2 (41.5 +/- 4.0, 52.0 +/- 8.7 and 50.6 +/- 9.0 ml/kg per min, respectively), maximal treadmill speed (9.9 +/- 1.2, 12.7 +/- 1.9 and 15.5 +/- 1.5 km/h) and HRR (65 +/- 17, 101 +/- 12 and 110 +/- 11 beats per minute [bpm]), which were significantly lower in the HTR group (p < 0.05). Regardless of type of organ transplant, both HTR and KTR patients had a similar VO2/treadmill speed relationship, significantly higher than in the CS group. HRR correlated with maximal VO2 for HTRs (r = 0.72, p < 0.05). CONCLUSIONS: Despite regular training, the decreased mechanical efficiency reflected by an increased VO2/treadmill speed relationship suggests a peripheral limitation in both heart and kidney transplant patients. Furthermore, exercise limitations in HTRs likely arose from both central and peripheral factors, in view of their specific HRR reduction. These factors probably contributed to the decreased speed and VO2 observed in the HTR group.
Authors:
Ruddy Richard; Jean-Claude Verdier; Stéphane Doutreleau; François Piquard; Bernard Gény; Michel Rieu
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2005-08-19
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  24     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-21     Completed Date:  2006-06-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1774-80     Citation Subset:  IM    
Affiliation:
Service de Physiologie et des Explorations Fonctionnelles, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. ruddy.richard@physio-ulp.u-strasbg.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Exercise Tolerance / physiology*
Heart Rate
Heart Transplantation / physiology*
Humans
Kidney Transplantation / physiology*
Male
Middle Aged
Oxygen Consumption
Stroke Volume
Ventricular Function, Left

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