Physical capacity in LVAD patients: hemodynamic principles, diagnostic tools and training control.
Over time left ventricular assist devices (LVAD) have become an alternative to heart transplantation because of enormous technical development and miniaturization. Most patients present a significant improvement in clinical conditions and exercise capacity. Nevertheless, exercise tolerance remains markedly limited even after LVAD implantation compared to a control group. The complex physiological and hemodynamic changes in LVAD patients, both at rest and during exercise, are not yet understood, or at least not completely.It is the aim of the present paper to describe the current state of scientific knowledge. Furthermore, the spectrum of diagnostic tools, including the noninvasive inert gas rebreathing method for measurement of cardiac output and associate parameters, are discussed. Options for training control in this special patient group are presented.
Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde - Germany.
Nils
N
Reiss
Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde - Germany.
Thomas
T
Schmidt
Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde - Germany.|Institute for Cardiology and Sports Medicine, German Sport University Cologne, Cologne - Germany.
Anke
A
Workowski
Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde - Germany.
Detlev
D
Willemsen
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover - Germany.
Jan D
JD
Schmitto
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover - Germany.
Axel
A
Haverich
Institute for Cardiology and Sports Medicine, German Sport University Cologne, Cologne - Germany.
Birna
B
Bjarnason-Wehrens
D002302:Cardiac Output / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D017079:Exercise Tolerance / Q000502:physiology*; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D012146:Rest / Q000502:physiology