1. Exercise blood pressure response during assisted circulatory support: comparison of the total artificial [corrected] heart with a left ventricular assist device during rehabilitation.
- Author
-
Kohli HS, Canada J, Arena R, Tang DG, Peberdy MA, Harton S, Flattery M, Doolin K, Katlaps GJ, Hess ML, Kasirajan V, and Shah KB
- Subjects
- Exercise Test, Female, Follow-Up Studies, Heart Failure physiopathology, Heart-Assist Devices, Humans, Male, Middle Aged, Prosthesis Design, Retrospective Studies, Blood Pressure physiology, Exercise physiology, Exercise Tolerance, Heart Failure rehabilitation, Heart Ventricles physiopathology, Heart, Artificial, Ventricular Function, Left physiology
- Abstract
Background: The total artificial heart (TAH) consists of two implantable pneumatic pumps that replace the heart and operate at a fixed ejection rate and ejection pressure. We evaluated the blood pressure (BP) response to exercise and exercise performance in patients with a TAH compared to those with a with a continuous-flow left ventricular assist device (LVAD)., Methods: We conducted a single-center, retrospective study of 37 patients who received a TAH and 12 patients implanted with an LVAD. We measured the BP response during exercise, exercise duration and change in tolerated exercise workload over an 8-week period., Results: In patients with a TAH, baseline BP was 120/69 ± 13/13, exercise BP was 118/72 ± 15/10 and post-exercise BP was 120/72 ± 14/12. Mean arterial BP did not change with exercise in patients with a TAH (88 ± 10 vs 88 ± 11; p = 0.8), but increased in those with an LVAD (87 ± 8 vs 95 ± 13; p < 0.001). Although the mean arterial BP (MAP) was negatively correlated with metabolic equivalents (METs) achieved during exercise, the association was not statistically significant (β = -0.1, p = 0.4). MAP correlated positively with METs achieved in patients with LVADs (MAP: β = 0.26, p = 0.04). Despite the abnormal response to exercise, patients with a TAH participated in physical therapy (median: 5 days; interquartile range [IQR] 4 to 7 days) and treadmill exercise (19 days; IQR: 13 to 35 days) early after device implantation, with increased exercise intensity and duration over time., Conclusions: During circulatory support with a TAH, the BP response to exercise was blunted. However, aerobic exercise training early after device implantation was found to be safe and feasible in a supervised setting., (2011 International Society for Heart and Lung Transplantation. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF