Gas exchange kinetics in heart transplant recipients

Submaximal and/or peak levels of oxygen consumption (VO2), pulmonary ventilation (VE), heart rate (HR), stroke volume of heart (SV), cardiac output (Q), muscle blood flow (qm), as well as the kinetics of readjustment of gas exchange, Q and qm (t1/2 VO2on-, t1/2 Qon-, t1/2 qmon-) were determined in 44 heart transplant recipients (HTRs) and in a group of age-, sex-, and physical activity-matched control subjects (CTL) when carrying out rectangular loads (25 to 125 W) on a bicycle ergometer. The increase of SV occurring at work onset appears to compensate in HTRs for the sluggish readjustment of HR so that the rate of readjustment of Q is kept within normal limits. As a consequence, qm, t1/2 q mon-, and t1/2 VO2on- appear to be similar or only moderately delayed in HTRs compared with CTLs. It is concluded that in HTRs, because of constrained maximum HR, only work loads up to 60% of the VO2max of CTLs may be attained; also, owing to the fast readjustment of Q, up to work loads of 75 to 100 W, the rest to work transition phase is not impaired.