Attenuated responses of Doppler-derived hemodynamic parameters during supine bicycle exercise in heart transplant...

The aim of this study was to characterize Doppler-derived hemodynamic parameters in heart transplant recipients at rest and during symptom-limited supine bicycle exercise. Eighteen sedentary patients aged 54.0 +/- 2 years, 1.6 +/- 1.0 years following cardiac transplantation, and 18 sedentary healthy volunteers aged 51.8 +/- 4 years were investigated. Basic hemodynamic parameters and Doppler-derived parameters were recorded at rest and at peak dynamic exercise. Resting heart rate, blood pressure and rate-pressure product were higher in the transplanted patients (p < 0.001). However, in comparison with the resting state, the increase in these parameters at exercise was lower in heart transplant recipients. In the healthy, dynamic exercise induced an increase in peak flow velocity, mean acceleration, flow velocity integral, stroke volume, cardiac output and cardiac index (p < 0.001 for all) while systemic vascular resistance, ejection time and acceleration time decreased (p < 0.001 for all). The following parameters increased in the transplanted patients at dynamic exercise: peak flow velocity, cardiac output and cardiac index (p < 0.001), mean acceleration (p < 0.01) and flow velocity integral (p < 0.05). Ejection time decreased (p < 0.05) and acceleration time and systemic vascular resistance remained unchanged. In conclusion, at rest peak flow velocity, mean acceleration, flow velocity integral and stroke volume are lower in the transplanted than in the healthy controls, while cardiac output, cardiac index and systemic vascular resistance are equal. Our study demonstrates attenuated responses of basic hemodynamic parameters and Doppler-derived cardiovascular indices at symptom-limited supine bicycle exercise in heart transplant recipients compared to healthy volunteers.