Case report on PWC of a competitive cyclist before and after heart transplant

It has been well documented that for heart transplant recipients (HTR), posttransplantation physical work capacity (PWC) normally does not exceed 60% of the value for healthy age-matched controls. Few, if any, studies have undertaken posttransplantation PWC measurements of well-conditioned individuals (i.e., PWC>300 W).

A 37-yr-old professionally trained male cyclist suffered an acute myocardial infarction (AMI) immediately after a road race and received a heart transplant (HT) 4 months after the AMI. The participant resumed training 1 month after surgery and underwent a maximal exercise test 6 months after surgery. Peak PWC (33.8 mL.kg(-1).min(-1), 250 W) was 92% of the age-predicted maximum, and peak heart rate (165 bpm) was 96% of his known maximum. These results were similar to the participants in a study who had been training regularly for 36+/-24 months before testing, and PWC evaluations occurred 43+/-12 months after HT.

Results suggest that 1) lifestyle before HT may positively affect posttransplantation PWC, 2) exercise capacity was not limited by chronotropic incompetence, and 3) a more aggressive approach to HT recovery could be applied to HTR with similar activity histories.