Comparison of functional capacity in patients with end-stage heart failure following implantation of a left ventricular assist device versus heart transplantation

Results of the experience with left ventricular assist device with exercise trial

Brian E. Jaski, Robert J. Lingle, Joseph Kim, Kelley R. Branch, Rochelle Goldsmith, Maryl R. Johnson, Jaap R. Lahpor, Timothy B. Icenogle, Ileana L. Pina, Robert Adamson, Laurence K. Favrot, Walter P. Dembitsky

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Background: Use of a permanent left ventricular assist device (LVAD) has been proposed as an alternate treatment of patients with end-stage heart failure. The purpose of this study was to compare the functional capacity of patients following implantation of a LVAD vs heart transplant (HTx). Methods: Eighteen patients from 6 centers who received an intracorporeal LVAD as a bridge to HTx underwent treadmill testing 1 to 3 months post-LVAD and again post-HTx. Baseline and peak measurements, including oxygen consumption, blood pressures, and respiratory rate were made during each treadmill test. Results: Peak oxygen consumption was 14.5 ± 3.9 ml/kg/minute post-LVAD and 17.5 ± 5.0 ml/kg/minute post-HTx (p < .005). The percentage of the predicted peak oxygen consumption based on gender, weight, and age was 39.5% ± 5.5% post-LVAD and 47.7% ± 10.9% post-HTx (p < .005). Exercise duration was lower post-LVAD than post-HTx (10.3 ± 4.2 minute vs 12.5 ± 5.4 minute, p < .05). After LVAD implantation, peak total oxygen consumption correlated with peak LVAD rate and output. Eight patients reached an LVAD rate of 120 beats per minute (bpm) before the conclusion of exercise, the maximum rate for the outpatient electric device. The peak respiratory exchange ratio post-LVAD was 1.15 ± 0.22 and post-HTx was 1.15 ± 0.18, consistent with a good effort in both groups. Conclusions: Patients demonstrated a lower functional capacity post-LVAD than post-HTx. For some patients functional capacity post-LVAD may be improved by a higher maximum LVAD rate and output. Copyright (C) 1999 International Society for Heart and Lung Transplantation.

Original languageEnglish (US)
Pages (from-to)1031-1040
Number of pages10
JournalJournal of Heart and Lung Transplantation
Volume18
Issue number11
DOIs
StatePublished - Nov 1999
Externally publishedYes

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Heart-Assist Devices
Heart Transplantation
Heart Failure
Exercise
Oxygen Consumption
Respiratory Rate
Exercise Test

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Comparison of functional capacity in patients with end-stage heart failure following implantation of a left ventricular assist device versus heart transplantation : Results of the experience with left ventricular assist device with exercise trial. / Jaski, Brian E.; Lingle, Robert J.; Kim, Joseph; Branch, Kelley R.; Goldsmith, Rochelle; Johnson, Maryl R.; Lahpor, Jaap R.; Icenogle, Timothy B.; Pina, Ileana L.; Adamson, Robert; Favrot, Laurence K.; Dembitsky, Walter P.

In: Journal of Heart and Lung Transplantation, Vol. 18, No. 11, 11.1999, p. 1031-1040.

Research output: Contribution to journalArticle

Jaski, Brian E. ; Lingle, Robert J. ; Kim, Joseph ; Branch, Kelley R. ; Goldsmith, Rochelle ; Johnson, Maryl R. ; Lahpor, Jaap R. ; Icenogle, Timothy B. ; Pina, Ileana L. ; Adamson, Robert ; Favrot, Laurence K. ; Dembitsky, Walter P. / Comparison of functional capacity in patients with end-stage heart failure following implantation of a left ventricular assist device versus heart transplantation : Results of the experience with left ventricular assist device with exercise trial. In: Journal of Heart and Lung Transplantation. 1999 ; Vol. 18, No. 11. pp. 1031-1040.
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abstract = "Background: Use of a permanent left ventricular assist device (LVAD) has been proposed as an alternate treatment of patients with end-stage heart failure. The purpose of this study was to compare the functional capacity of patients following implantation of a LVAD vs heart transplant (HTx). Methods: Eighteen patients from 6 centers who received an intracorporeal LVAD as a bridge to HTx underwent treadmill testing 1 to 3 months post-LVAD and again post-HTx. Baseline and peak measurements, including oxygen consumption, blood pressures, and respiratory rate were made during each treadmill test. Results: Peak oxygen consumption was 14.5 ± 3.9 ml/kg/minute post-LVAD and 17.5 ± 5.0 ml/kg/minute post-HTx (p < .005). The percentage of the predicted peak oxygen consumption based on gender, weight, and age was 39.5{\%} ± 5.5{\%} post-LVAD and 47.7{\%} ± 10.9{\%} post-HTx (p < .005). Exercise duration was lower post-LVAD than post-HTx (10.3 ± 4.2 minute vs 12.5 ± 5.4 minute, p < .05). After LVAD implantation, peak total oxygen consumption correlated with peak LVAD rate and output. Eight patients reached an LVAD rate of 120 beats per minute (bpm) before the conclusion of exercise, the maximum rate for the outpatient electric device. The peak respiratory exchange ratio post-LVAD was 1.15 ± 0.22 and post-HTx was 1.15 ± 0.18, consistent with a good effort in both groups. Conclusions: Patients demonstrated a lower functional capacity post-LVAD than post-HTx. For some patients functional capacity post-LVAD may be improved by a higher maximum LVAD rate and output. Copyright (C) 1999 International Society for Heart and Lung Transplantation.",
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AU - Lingle, Robert J.

AU - Kim, Joseph

AU - Branch, Kelley R.

AU - Goldsmith, Rochelle

AU - Johnson, Maryl R.

AU - Lahpor, Jaap R.

AU - Icenogle, Timothy B.

AU - Pina, Ileana L.

AU - Adamson, Robert

AU - Favrot, Laurence K.

AU - Dembitsky, Walter P.

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