title: Effect of left ventricular assist device implantation and heart transplantation on habitual physical activity and quality of life.
abstract: The present study defined the short- and long-term effects of left ventricular assist device (LVAD) implantation and heart transplantation (HT) on physical activity and quality of life (QoL). Forty patients (LVAD, n = 14; HT, n = 12; and heart failure [HF], n = 14) and 14 matched healthy subjects were assessed for physical activity, energy expenditure, and QoL. The LVAD and HT groups were assessed postoperatively at 4 to 6 weeks (baseline) and 3, 6, and 12 months. At baseline, LVAD, HT, and HF patients demonstrated low physical activity, reaching only 15%, 28%, and 51% of that of healthy subjects (1,603 ± 302 vs 3,036 ± 439 vs 5,490 ± 1,058 vs 10,756 ± 568 steps/day, respectively, p <0.01). This was associated with reduced energy expenditure and increased sedentary time (p <0.01). Baseline QoL was not different among LVAD, HT, and HF groups (p = 0.44). LVAD implantation and HT significantly increased daily physical activity by 60% and 52%, respectively, from baseline to 3 months (p <0.05), but the level of activity remained unchanged at 3, 6, and 12 months. The QoL improved from baseline to 3 months in LVAD implantation and HT groups (p <0.01) but remained unchanged afterward. At any time point, HT demonstrated higher activity level than LVAD implantation (p <0.05), and this was associated with better QoL. In contrast, physical activity and QoL decreased at 12 months in patients with HF (p <0.05). In conclusion, patients in LVAD and HT patients demonstrate improved physical activity and QoL within the first 3 months after surgery, but physical activity and QoL remain unchanged afterward and well below that of healthy subjects. Strategies targeting low levels of physical activity should now be explored to improve recovery of these patients.
authors.affiliation: Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom. Electronic address: d.jakovljevic@ncl.ac.uk.
authors.forename: Djordje G
authors.initials: DG
authors.lastname: Jakovljevic
authors.affiliation: Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
authors.forename: Adam
authors.initials: A
authors.lastname: McDiarmid
authors.affiliation: Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Kate
authors.initials: K
authors.lastname: Hallsworth
authors.affiliation: Cardiology Department, Clinical Centre of Serbia, Medical School, University of Belgrade, Belgrade, Serbia.
authors.forename: Petar M
authors.initials: PM
authors.lastname: Seferovic
authors.affiliation: Department of Cardiology, Specialistic Hospital Merkur, Vrnjacka Banja, Serbia.
authors.forename: Vladan M
authors.initials: VM
authors.lastname: Ninkovic
authors.affiliation: Departments of Cardiothoracic Surgery and Transplantation, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
authors.forename: Gareth
authors.initials: G
authors.lastname: Parry
authors.affiliation: Departments of Cardiothoracic Surgery and Transplantation, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
authors.forename: Stephan
authors.initials: S
authors.lastname: Schueler
authors.affiliation: Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Trenell
authors.affiliation: Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom; Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Guy A
authors.initials: GA
authors.lastname: MacGowan
mesh_terms: D000203:Activities of Daily Living; D016022:Case-Control Studies; D004734:Energy Metabolism; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D016896:Treatment Outcome