Prognostic Relevance of Poor Physical Performance After a Short Period of Intensive Cardiac Rehabilitation in the Early Phase of Axial-flow LVAD Support: A Preliminary Report.
Long-term support of Chronic Heart Failure patients by a Left Ventricular Assist Device leads to an increase of the circulatory output and an overall improvement of clinical compensation and survival rate. In the last few years, axial-flow rotatory pumps have been increasingly utilized; these pumps
have proven effective in providing a valid hemodynamic support
and have shown a favourable risk-to-benefit ratio.
Although it is currently known that the positive changes on circulatory function occur early after beginning of LVAD support, there is a definite lack of studies assessing the exercise
capacity of LVAD patients in the initial phases of circulatory support. Little
is still known also about the relationship between
physical fitness in the early phases and long-term overall mortality.
To the best of our knowledge, during the first 3 months since device implantation a
rather limited number of patients supported by axial-flow LVADs has been observed
so far in a few studies. These studies demonstrated that the exercise capacity and
the hemodynamic-respiratory findings persisted poor despite the mechanical support, with values of peak oxygen uptake reported to be around 50% of the expected values.
Only the study by Hasin et al described the relationship between persistent exercise intolerance in the early period after beginning of axial-flow LVAD support and worse long-term prognosis; in that
study, anyway, patients observed within the first 2 months since device implantation
have been excluded from analysis.
Heart Res Open J. 2016; SE(1): S4-S15. doi: 10.17140/HROJ-SE-1-102
