Functional Performance in Patients with Mechanical Circulatory Support Systems at Discharge from Exercise-Based Inpatient Cardiac Rehabilitation

Thomas Schmidt, E Langheim, Birna Bjarnason-Wehrens, Hans-Georg Predel, Nils Reiss, J Glatz

Publication: Contribution to journalConference abstract in journalResearchpeer-review


Purpose: Following MCS implantation adequate functional performance is crucial for participation in self-determined social life. Exercise-based cardiac rehabilitation (CR) is intended to make an important contribution to recovery before patients can be discharged home. It was our aim to evaluate functional performance measured with the six-minute walking distance (6MWD) at the end of inpatient CR and possible influencing factors.Methods: Retrospective analysis of monocentric quality assurance data: we included patients (≥18 years old) who underwent MCS implantation between 2006 and 2016 and subsequently completed exercise-based inpatient CR. 6MWD was measured routinely at begin and end of CR. In total the results of 435 patients (54§12 yrs old, 16% female, 42%DCM, 43% ICM, 9% myocarditis) with MCS support (413 LVAD, 17 BVAD, 2 RVAD, 3 TAH) could be analyzed.Results: CR began 54§42 days after implantation and lasted 24§6 days. Overall the 6MWD improved significantly from 292§109 to a total of 375§ 109 m (p<0.01). Analysis of variances (ANOVA) revealed no significant changes between the different support types (LVAD, BVAD, RVAD, TAH) in terms of reached improvements and total distances. Patients with ICM achieved a worse 6MWD (p<0.01) compared to patients with DCM (351§102 vs. 392§ 111 m). Highest 6MWD was achieved by patients after myocarditis (427§103 m) reflecting both possible cardiac reserve and also younger age compared to ICM group (p<0.01). Patients with atrial fibrillation (22%) achieved a lower 6MWD compared to patients with sinus rhythm (342§97 vs. 384§112 m). Patients with at least intermittent opening of aortic valve (59%) reached greater improvements in 6MWD during CR compared to patients without aortic valve opening (p<0.05). Possible influences of MCS exchange (4%) or implantation of different cardiac rhythm devices (CRT, ICD, PM) (in total 84%) did not affect functional performance.Conclusion: In patients with MCS systems 6MWD improved significantly during exercise-based inpatient CR regardless from different support types. The reached distance of about 375 m reflects adequate functional performance as prerequisite for the activities of daily living. In the future, randomized and controlled studies should be sought to verify and confirm the effects of exercise-based CR in patients with MCS.
Original languageEnglish
Article number847
JournalThe journal of heart and lung transplantation
Issue number4, Supplement
Pages (from-to)S340
Number of pages1
Publication statusPublished - 04.2020


Dive into the research topics of 'Functional Performance in Patients with Mechanical Circulatory Support Systems at Discharge from Exercise-Based Inpatient Cardiac Rehabilitation'. Together they form a unique fingerprint.