Clinical features and determinants of VO_2peak in de novo heart transplant recipients

TY - JOUR

T1 - Clinical features and determinants of VO2peak in de novo heart transplant recipients

AU - Rolid, Katrine

AU - Andreassen, Arne K

AU - Yardley, Marianne

AU - Bjørkelund, Elisabeth

AU - Karason, Kristjan

AU - Wigh, Julia P

AU - Dall, Christian H

AU - Gustafsson, Finn

AU - Gullestad, Lars

AU - Nytrøen, Kari

PY - 2018

Y1 - 2018

N2 - AIM: To study exercise capacity and determinants of early peak oxygen consumption (VO2peak) in a cohort of de novo heart transplant (HTx) recipients.METHODS: To determine possible central (chronotropic responses, cardiopulmonary and hemodynamic function) and peripheral factors (muscular exercise capacity and body composition) predictive of VO2peak, a number of different measurements and tests were performed, as follows: Cardiopulmonary exercise testing (CPET) was performed mean 11 wk after surgery in 81 HTx recipients > 18 years and was measured with breath by breath gas exchange on a treadmill or bicycle ergometer. Metabolic/respiratory measures include VO2peak and VE/VCO2 slope. Additional measures included muscle strength testing, bioelectrical impedance analysis, echocardiography, blood sampling and health-related quality of life. Based on the VO2peak (mL/kg per minute) median value, the study population was divided into two groups defined as a low-capacity group and a high-capacity group. Potential predictors were analyzed using multiple regression analysis with VO2peak (L/min) as the dependent variable.RESULTS: The mean ± standard deviation (SD) age of the total study population was 49 ± 13 years, and 73% were men. This de novo HTx cohort demonstrated a median VO2peak level of 19.4 mL/kg per min at 11 ± 1.8 wk post-HTx. As compared with the high-capacity group, the low-capacity group exercised for a shorter time, had lower maximal ventilation, O2 pulse, peak heart rate and heart rate reserve, while the VE/VCO2 slope was higher. The low-capacity group had less muscle strength and muscular exercise capacity in comparison with the high-capacity group. In order of importance, O2 pulse, heart rate reserve, muscular exercise capacity, body mass index, gender and age accounted for 84% of the variance in VO2peak (L/min). There were no minor or major serious adverse events during the CPET.CONCLUSION: Although there is great individual variance among de novo HTx recipients, early VO2peak measures appear to be influenced by both central and peripheral factors.

AB - AIM: To study exercise capacity and determinants of early peak oxygen consumption (VO2peak) in a cohort of de novo heart transplant (HTx) recipients.METHODS: To determine possible central (chronotropic responses, cardiopulmonary and hemodynamic function) and peripheral factors (muscular exercise capacity and body composition) predictive of VO2peak, a number of different measurements and tests were performed, as follows: Cardiopulmonary exercise testing (CPET) was performed mean 11 wk after surgery in 81 HTx recipients > 18 years and was measured with breath by breath gas exchange on a treadmill or bicycle ergometer. Metabolic/respiratory measures include VO2peak and VE/VCO2 slope. Additional measures included muscle strength testing, bioelectrical impedance analysis, echocardiography, blood sampling and health-related quality of life. Based on the VO2peak (mL/kg per minute) median value, the study population was divided into two groups defined as a low-capacity group and a high-capacity group. Potential predictors were analyzed using multiple regression analysis with VO2peak (L/min) as the dependent variable.RESULTS: The mean ± standard deviation (SD) age of the total study population was 49 ± 13 years, and 73% were men. This de novo HTx cohort demonstrated a median VO2peak level of 19.4 mL/kg per min at 11 ± 1.8 wk post-HTx. As compared with the high-capacity group, the low-capacity group exercised for a shorter time, had lower maximal ventilation, O2 pulse, peak heart rate and heart rate reserve, while the VE/VCO2 slope was higher. The low-capacity group had less muscle strength and muscular exercise capacity in comparison with the high-capacity group. In order of importance, O2 pulse, heart rate reserve, muscular exercise capacity, body mass index, gender and age accounted for 84% of the variance in VO2peak (L/min). There were no minor or major serious adverse events during the CPET.CONCLUSION: Although there is great individual variance among de novo HTx recipients, early VO2peak measures appear to be influenced by both central and peripheral factors.

U2 - 10.5500/wjt.v8.i5.188

DO - 10.5500/wjt.v8.i5.188

M3 - Journal article

C2 - 30211027

SN - 2220-3230

VL - 8

SP - 188

EP - 197

JO - World Journal of Transplantation

JF - World Journal of Transplantation

IS - 5

ER -