TY - JOUR
T1 - Differential exercise performance on ventricular assist device support
AU - Simon, Marc A.
AU - Kormos, Robert L.
AU - Gorcsan, John
AU - Dohi, Kaoru
AU - Winowich, Steve
AU - Stanford, Eileen
AU - Carozza, Lisa
AU - Murali, Srinivas
PY - 2005/10
Y1 - 2005/10
N2 - Background: Ventricular assist devices (VADs) are approved for destination therapy because they improve survival in end-stage heart failure (HF). VADs are powered pneumatically or electrically. Pneumatic and electric left ventricular assist devices (LVADs) and biventricular assist devices (BiVADs) provide excellent hemodynamic support at rest, but differences in their effects on exercise tolerance are unclear. We sought to evaluate the effect of devices with varying operating parameters on exercise capacity. Methods: Exercise physiology data obtained during maximal exercise with on-line gas-exchange analysis were collected for 38 consecutive VAD-implanted HF patients referred for exercise testing. Results: Electric LVADs were implanted in 18 patients, and pneumatic LVADs in 10 patients. Percent of predicted peak exercise oxygen consumption (Vo2%) was significantly greater in pneumatic LVAD patients (52.1 ± 11.1% vs 38.2 ± 11.3%, p < 0.05). The 10 patients implanted with a pneumatically powered LVAD were compared to 10 patients implanted with a pneumatically powered BiVAD. LVAD-supported patients had a higher Vo 2% (52.1 ± 11.1% vs 36.5 ± 17.7%, p < 0.05). Conclusions: HF patients supported with a pneumatic LVAD appear to have better exercise tolerance than those receiving an electric LVAD. Patients on LVAD support have better exercise tolerance than BiVAD-supported patients. This highlights the importance of right ventricular function to exercise tolerance in HF patients, and may have implications for future VAD design.
AB - Background: Ventricular assist devices (VADs) are approved for destination therapy because they improve survival in end-stage heart failure (HF). VADs are powered pneumatically or electrically. Pneumatic and electric left ventricular assist devices (LVADs) and biventricular assist devices (BiVADs) provide excellent hemodynamic support at rest, but differences in their effects on exercise tolerance are unclear. We sought to evaluate the effect of devices with varying operating parameters on exercise capacity. Methods: Exercise physiology data obtained during maximal exercise with on-line gas-exchange analysis were collected for 38 consecutive VAD-implanted HF patients referred for exercise testing. Results: Electric LVADs were implanted in 18 patients, and pneumatic LVADs in 10 patients. Percent of predicted peak exercise oxygen consumption (Vo2%) was significantly greater in pneumatic LVAD patients (52.1 ± 11.1% vs 38.2 ± 11.3%, p < 0.05). The 10 patients implanted with a pneumatically powered LVAD were compared to 10 patients implanted with a pneumatically powered BiVAD. LVAD-supported patients had a higher Vo 2% (52.1 ± 11.1% vs 36.5 ± 17.7%, p < 0.05). Conclusions: HF patients supported with a pneumatic LVAD appear to have better exercise tolerance than those receiving an electric LVAD. Patients on LVAD support have better exercise tolerance than BiVAD-supported patients. This highlights the importance of right ventricular function to exercise tolerance in HF patients, and may have implications for future VAD design.
UR - http://www.scopus.com/inward/record.url?scp=25844436253&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2004.11.054
DO - 10.1016/j.healun.2004.11.054
M3 - Article
C2 - 16210122
AN - SCOPUS:25844436253
VL - 24
SP - 1506
EP - 1512
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
IS - 10
ER -