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Exercise Capacity in Patients with the Total Artificial Heart
Justin M Canada1,2, Ronald K Evans1, Antonio Abbate2
1From the Department of Kinesiology & Health Sciences, Virginia Commonwealth University, Richmond, Virginia.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|January 12, 2018
Summary
Patients with a total artificial heart (TAH) show significantly reduced exercise capacity. This study quantifies their functional abilities, revealing limitations in cardiac output modulation and oxygen use during physical activity.
Area of Science:
- Cardiovascular Medicine
- Rehabilitation Science
- Biomedical Engineering
Background:
- Limited data exists on the functional capacity of total artificial heart (TAH) recipients.
- Growing TAH utilization and home discharge necessitate quality of life assessments.
- Previous exercise response data is confined to single-patient case studies.
Purpose of the Study:
- To quantify the exercise performance and functional capacity of TAH patients.
- To identify limitations in cardiopulmonary exercise testing (CPET) for TAH recipients.
- To correlate device function with exercise outcomes.
Main Methods:
- Fourteen TAH patients underwent CPET with concurrent TAH device function monitoring.
- Device settings were kept constant throughout the testing period.
- Analysis included peak oxygen consumption (VO2), percent predicted VO2, and ventilatory anaerobic threshold.
Main Results:
- TAH patients exhibited markedly reduced peak VO2 (36% predicted) and ventilatory anaerobic threshold compared to normal values.
- Exercise response showed a blunted cardiac output increase (+9%) and exaggerated oxygen extraction.
- Peak VO2 strongly correlated with resting, ventilatory anaerobic threshold, and peak exercise cardiac output.
Conclusions:
- TAH patients have significantly impaired exercise performance.
- Limitations stem from the TAH's inability to modulate output effectively during activity.
- Reduced oxygen-carrying capacity also contributes to exercise limitations.
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