Changes in Total Cardiac Output and Oxygen Extraction During Exercise in Patients Supported With an HVAD Left Ventricular Assist Device

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Changes in Total Cardiac Output and Oxygen Extraction During Exercise in Patients Supported With an HVAD Left Ventricular Assist Device. / Schmidt, Thomas; Bjarnason-Wehrens, Birna; Mommertz, Stephanie; Hannig, Meike; Schulte-Eistrup, Sebastian; Willemsen, Detlev; Reiss, Nils.

in: Artificial organs, Jahrgang 42, Nr. 7, 07.2018, S. 686-694.

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@article{d9356f45afee4f5dbd007f3d681925b4,
title = "Changes in Total Cardiac Output and Oxygen Extraction During Exercise in Patients Supported With an HVAD Left Ventricular Assist Device",
abstract = "Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO2 ). We investigated the changes in CO and avDO2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60.8 ± 7.3 years old, BMI 25.7 ± 3.3) underwent a six-minute walk test (6MWT), a cardiopulmonary exercise test (CPET), and noninvasive hemodynamic measurement. The mean six-minute walking distance (6MWD) was 403 m (68% of predicted), and mean peak VO2 was 10.9 mL/kg/min (39% of predicted). Mean total CO improved from 3.8 L at rest to 7.0 L at maximum exercise. The mean avDO2 increased from 7.4 mL/dL (44% of oxygen content) at rest to 13.2 mL/dL (75% of oxygen content) at maximum exercise. There was a significant increase in both total CO (P < 0.01) and avDO2 (P < 0.05) between rest and sub-maximum exercise. As exercise levels increased, however, no further significant changes were achieved. Long-term studies, especially in combination with exercise programs, would be desirable in order to observe the development of these parameters.",
keywords = "Aged, Cardiac Output, Cardiomyopathies, Exercise, Exercise Test, Female, Heart Failure, Heart-Assist Devices, Hemodynamics, Humans, Male, Middle Aged, Oxygen, Oxygen Consumption, Prosthesis Implantation, Quality of Life, Ventricular Function, Left, Journal Article",
author = "Thomas Schmidt and Birna Bjarnason-Wehrens and Stephanie Mommertz and Meike Hannig and Sebastian Schulte-Eistrup and Detlev Willemsen and Nils Reiss",
note = "{\textcopyright} 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.",
year = "2018",
month = jul,
language = "English",
volume = "42",
pages = "686--694",
journal = "Artificial organs",
issn = "0160-564X",
publisher = "Wiley-Blackwell",
number = "7",

}

RIS

TY - JOUR

T1 - Changes in Total Cardiac Output and Oxygen Extraction During Exercise in Patients Supported With an HVAD Left Ventricular Assist Device

AU - Schmidt, Thomas

AU - Bjarnason-Wehrens, Birna

AU - Mommertz, Stephanie

AU - Hannig, Meike

AU - Schulte-Eistrup, Sebastian

AU - Willemsen, Detlev

AU - Reiss, Nils

N1 - © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

PY - 2018/7

Y1 - 2018/7

N2 - Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO2 ). We investigated the changes in CO and avDO2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60.8 ± 7.3 years old, BMI 25.7 ± 3.3) underwent a six-minute walk test (6MWT), a cardiopulmonary exercise test (CPET), and noninvasive hemodynamic measurement. The mean six-minute walking distance (6MWD) was 403 m (68% of predicted), and mean peak VO2 was 10.9 mL/kg/min (39% of predicted). Mean total CO improved from 3.8 L at rest to 7.0 L at maximum exercise. The mean avDO2 increased from 7.4 mL/dL (44% of oxygen content) at rest to 13.2 mL/dL (75% of oxygen content) at maximum exercise. There was a significant increase in both total CO (P < 0.01) and avDO2 (P < 0.05) between rest and sub-maximum exercise. As exercise levels increased, however, no further significant changes were achieved. Long-term studies, especially in combination with exercise programs, would be desirable in order to observe the development of these parameters.

AB - Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO2 ). We investigated the changes in CO and avDO2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60.8 ± 7.3 years old, BMI 25.7 ± 3.3) underwent a six-minute walk test (6MWT), a cardiopulmonary exercise test (CPET), and noninvasive hemodynamic measurement. The mean six-minute walking distance (6MWD) was 403 m (68% of predicted), and mean peak VO2 was 10.9 mL/kg/min (39% of predicted). Mean total CO improved from 3.8 L at rest to 7.0 L at maximum exercise. The mean avDO2 increased from 7.4 mL/dL (44% of oxygen content) at rest to 13.2 mL/dL (75% of oxygen content) at maximum exercise. There was a significant increase in both total CO (P < 0.01) and avDO2 (P < 0.05) between rest and sub-maximum exercise. As exercise levels increased, however, no further significant changes were achieved. Long-term studies, especially in combination with exercise programs, would be desirable in order to observe the development of these parameters.

KW - Aged

KW - Cardiac Output

KW - Cardiomyopathies

KW - Exercise

KW - Exercise Test

KW - Female

KW - Heart Failure

KW - Heart-Assist Devices

KW - Hemodynamics

KW - Humans

KW - Male

KW - Middle Aged

KW - Oxygen

KW - Oxygen Consumption

KW - Prosthesis Implantation

KW - Quality of Life

KW - Ventricular Function, Left

KW - Journal Article

M3 - Journal articles

C2 - 29436010

VL - 42

SP - 686

EP - 694

JO - Artificial organs

JF - Artificial organs

SN - 0160-564X

IS - 7

ER -

ID: 3632394