[Exercise physiology and the rehabilitation of the heart transplant patient]

Cardiac transplantation has succeeded in improving the survival of the patients with terminal heart failure spectacularly. Nevertheless, in the transplant recipients the cardiac response to the effort is limited. In order to increase the cardiac output, the denervated heart needs an important increase of the precharge, since its chronotropic response is reduced. This rise of the precharge, in a restrictive heart in itself, leads to a disproportionate increase of the filling pressures. This limits the functional capacity of the patient due to the feeling of dyspnea. A program of cardiac rehabilitation, that includes a physical continued training, gets to improve the physiopathologic response to the exercise of the transplant heart.