Assessing exercise performance after heart transplantation.
OBJECTIVE
Heart transplantation improves the survival rate and quality of life in patients with severe symptoms of congestive heart failure and an ejection fraction of 20% or less. Despite marked symptomatic and clinical improvement in those who undergo heart transplantation, exercise capacity often remains reduced, and the factors limiting exercise performance during the post-transplantation period remain unclear. This study was performed to investigate the factors affecting exercise capacity in heart transplantation recipients.


METHODS
Fourteen patients with cardiomyopathy were enrolled in this study. We measured peak exercise oxygen uptake (peak VO(2)) in seven patients (age range: 42 +/- 14 yr) 10-28 months after transplantation, in seven patients (age range: 33 +/- 18 yr) with dilated cardiomyopathy before heart transplantation, and in 14 healthy control subjects (age range: 44 +/- 12 yr). The left ventricular ejection fraction, Beck Depression Inventory score, Medical Outcome Health Survey Short Form-36 Questionnaire (SF-36) results, and immunosuppressive therapy administered were recorded in all patient groups.


RESULTS
All patients in the post-transplantation group terminated exercise testing before the anaerobic threshold because of general fatigue. All heart transplantation recipients exhibited a left ventricular ejection fraction within the normal range (mean +/- SD = 57% +/- 2%). The peak VO(2) mean values were significantly different among the three groups (p = 0.001). There were statistically significant correlations between the peak VO(2) values and the Beck Depression Inventory scores (r = -0.637, p = 0.01), between the peak VO(2) values and bodily pain (r = 0.717, p = 0.006), between the peak VO(2) values and general health perceptions (r = 0.706, p = 0.007), and between peak VO(2) values and postoperative duration (r = 0.843, p = 0.03) in all patient groups.


CONCLUSIONS
In the long-term treatment of heart transplant recipients, exercise training should be considered an important therapeutic tool that enables patients to achieve a good quality of life.
Ulubay
Gaye
G
Department of Pulmonary Diseases, Faculty of Medicine, Baskent University, Ankara, Turkey. gulubay66@yahoo.com
Ulasli
Sevinc Sarinc
SS
Sezgin
Atilla
A
Haberal
Mehmet
M
D000328:Adult; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006305:Health Status Indicators; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011184:Postoperative Period; D011788:Quality of Life; D012129:Respiratory Function Tests