Document Detail


Exercise therapy for cardiac transplant recipients.
MedLine Citation:
PMID:  21545929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heart transplantation (HT) is an attractive treatment for patients with terminal heart failure from a variety of causes. Survival at 1- and 5 years after HT averages 90% and 70%, respectively. The physiologic response to exercise is abnormal after HT presumably because the transplanted heart is surgically denervated, although a minority of patients demonstrate signs of partial cardiac reinnervation several months after surgery. The heart rate response to exercise is typically blunted, and exercise capacity is below average for most HT recipients. Multiple studies have demonstrated the benefits of exercise training (ET) after HT. Peak exercise oxygen uptake improves by an average of 24% after 2 to 3 months of ET. Resistance training results in increased skeletal muscle mass and strength. Early mobilization and low-level ET may begin in the hospital after extubation. Outpatient ET, ideally in a supervised environment for at least several weeks, should begin immediately after hospital dismissal. Exercise prescription for HT patients is similar to that for other patients who have undergone cardiothoracic surgery, with the exception of a target heart rate. Ratings of perceived exertion are useful for prescribing exercise intensity. Exercise training does not affect the frequency or severity of episodes of acute rejection. There are no data regarding the effect of ET on survival after HT.
Authors:
Ray W Squires
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Progress in cardiovascular diseases     Volume:  53     ISSN:  1873-1740     ISO Abbreviation:  Prog Cardiovasc Dis     Publication Date:    2011 May-Jun
Date Detail:
Created Date:  2011-05-06     Completed Date:  2011-07-19     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  0376442     Medline TA:  Prog Cardiovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  429-36     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Cardiovascular Health and Rehabilitation, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. squires.ray@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Disease Progression
Exercise / physiology*
Exercise Therapy / methods*
Heart Failure / surgery*
Heart Transplantation* / mortality,  physiology,  rehabilitation
Humans
Prognosis
Survival Rate / trends
Treatment Outcome
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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