Document Detail

Exercise training with a heart device: a hemodynamic, metabolic, and hormonal study.
MedLine Citation:
PMID:  11194106     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The mechanisms of the training-induced improvements in left ventricular assist (LVAD) patients are unknown. METHODS: We measured the hemodynamic, gas exchange, and metabolic and hormonal effects of 6-wk exercise training in a cardiogenic shock patient who was assisted by an LVAD. RESULTS: After training, the peak power and VO2 increased by 166% and 56%, respectively (80 W and 16.1 mL x min(-1) x kg(-1)), whereas the ventilatory drive decreased. Although the LVAD output increased little with exercise, the systemic cardiac output rose (adequately for the VO2) from 5.91 and 4.90 L x min(-1) at rest to 9.75 and 9.47 L x min(-1) at peak work rate, before and after training, respectively. Thus, the left ventricle ejected again through the aortic valve. Unloading and/or retraining resulted in a left ventricular filling pressure decrease. Although the right ventricular ejection fraction increased with exercise, it decreased again at the maximal load after training. For a given work rate the arterial lactate, the norepinephrine (NE) and epinephrine (E) concentrations fell after training, but the enhanced maximal work rate elicited higher NE and E concentrations (4396 and 1848 pg x mL(-1), respectively). The lack of right ventricular unloading might have kept the atrial natriuretic peptide higher after training, but the blood cyclic GMP and endothelin were lower after training. CONCLUSION: In an LVAD patient, retraining returns the exercise capacity to the class III level by peripheral and left ventricular hemodynamic improvements, but the safety of maximal exercise remains to be proven in terms of right ventricular function and orthosympathetic drive.
B Mettauer; B Geny; E Lonsdorfer-Wolf; A Charloux; Q M Zhao; B Heitz-Naegelen; E Epailly; E Lampert; F Levy; J Lonsdorfer
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  33     ISSN:  0195-9131     ISO Abbreviation:  Med Sci Sports Exerc     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-18     Completed Date:  2001-04-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2-8     Citation Subset:  IM; S    
Jeune Equipe 2105, Faculté de Médecine, Strasbourg, France.
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MeSH Terms
Cardiomyopathies / metabolism,  physiopathology,  therapy*
Exercise / physiology*
Heart-Assist Devices*
Hemodynamics / physiology*
Hormones / metabolism,  physiology*
Middle Aged
Reg. No./Substance:

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