| Heart rate response determines long term exercise capacity after heart transplantation. | |
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MedLine Citation:
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PMID: 19492196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Exercise capacity after heart transplantation (HTx) remains limited despite normal left ventricular systolic function of the allograft. Various clinical and haemodynamic parameters are predictive of exercise capacity following HTx. However, the predictive significance of chronotropic competence has not been demonstrated unequivocally despite its immediate relevance for cardiac output. AIMS: This study assesses the predictive value of various clinical and haemodynamic parameters for exercise capacity in HTx recipients with complete chronotropic competence evolving within the first 6 postoperative months. METHODS: 51 patients were enrolled in this exercise study. Patients were included when at least >6 months after HTx and without negative chronotropic medication or factors limiting exercise capacity such as significant transplant vasculopathy or allograft rejection. Clinical parameters were obtained by chart review, haemodynamic parameters from current cardiac catheterisation, and exercise capacity was assessed by treadmill stress testing. A stepwise multiple regression model analysed the proportion of the variance explained by the predictive parameters. RESULTS: The mean age of these 51 HTx recipients was 55.4 +/- 13.2 yrs on inclusion, 42 pts were male and the mean time interval after cardiac transplantation was 5.1 +/- 2.8 yrs. Five independent predictors explained 47.5% of the variance observed for peak exercise capacity (adjusted R2 = 0.475). In detail, heart rate response explained 31.6%, male gender 5.2%, age 4.1%, pulmonary vascular resistance 3.7%, and body-mass index 2.9%. CONCLUSION: Heart rate response is one of the most important predictors of exercise capacity in HTx recipients with complete chronotropic competence and without relevant transplant vasculopathy or acute allograft rejection. |
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Authors:
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Ariane Käser; Michele Martinelli; Martin Feller; Thierry Carrel; Paul Mohacsi; Roger Hullin |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Swiss medical weekly Volume: 139 ISSN: 1424-7860 ISO Abbreviation: Swiss Med Wkly Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-06-03 Completed Date: 2009-09-03 Revised Date: 2011-02-15 |
Medline Journal Info:
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Nlm Unique ID: 100970884 Medline TA: Swiss Med Wkly Country: Switzerland |
Other Details:
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Languages: eng Pagination: 308-12 Citation Subset: IM |
Affiliation:
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Department of Cardiology, University Hospital, Bern, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Electrocardiography Exercise Test Exercise Tolerance / physiology* Female Follow-Up Studies Heart Failure / surgery* Heart Rate / physiology Heart Transplantation / physiology* Humans Male Middle Aged Prognosis Time Factors Treatment Outcome Vascular Resistance / physiology |
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