title: Peripheral adaptation mechanisms in physical training and cardiac rehabilitation: the case of a patient supported by a CardioWest total artificial heart.
abstract: BACKGROUND
  The benefits of exercise training in patients with chronic heart failure (CHF) are due to a combination of cardiac and peripheral adaptations. Separating these 2 components is normally impossible, except for patients implanted with total artificial heart (TAH), where cardiac adaptation cannot occur.
  
  
  RESULTS
  We report the case of a patient implanted with a CardioWest-TAH who underwent a comprehensive strength and endurance training program and was evaluated by repeated peak cardiopulmonary exercise tests. The patient experienced a 24% increase of peak oxygen consumption and an improvement in recovery kinetics during the training period of 29 months.
  
  
  CONCLUSIONS
  This unique situation of a patient with a TAH, and therefore a fixed peak cardiac output, allows us to isolate training-induced changes in the periphery, that suggest greater oxygen extraction and more efficient metabolic gas kinetics during the exercise and recovery phases.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Bellotto
authors.forename: Leonida
authors.initials: L
authors.lastname: Compostella
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
authors.forename: Gianluca
authors.initials: G
authors.lastname: Torregrossa
authors.forename: Tiziana
authors.initials: T
authors.lastname: Setzu
authors.forename: Antonio
authors.initials: A
authors.lastname: Gambino
authors.forename: Nicola
authors.initials: N
authors.lastname: Russo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Feltrin
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tarzia
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D006354:Heart, Artificial; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged