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Comparison of cardiac power output and exercise performance in patients with left ventricular assist devices, explanted (recovered) patients and those with moderate to severe heart failure

Lookup NU author(s): Dr Djordje Jakovljevic

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Abstract

Peak cardiac power output (CPO), as a direct measure of overall cardiac function, has been shown to be a most powerful predictor of prognosis for patients with chronic heart failure. The present study assessed CPO and exercise performance in patients implanted with a left ventricular assist device (LVAD), those explanted due to myocardial recovery and in those with moderate to severe heart failure. Hemodynamic and respiratory gas exchange measurements were undertaken at rest and at peak graded exercise. They were performed on 54 patients – 20 moderate to severe heart failure patients, 18 LVAD implanted patients and 16 LVAD explanted patients. At rest there was a non significant difference in cardiac power output between the groups (p>0.05). Peak CPO was significantly higher in the LVAD explanted than in the heart failure and the LVAD implanted patients (heart failure, 1.90±0.45; implanted, 2.37±0.55; explanted, 3.39±0.61 W; p<0.01) as was peak cardiac output (heart failure, 9.1±2.1; implanted, 12.4±2.2; explanted, 14.6±2.9 l.min-1; p<0.01). Peak oxygen consumption was higher in the LVAD explanted than the heart failure and the implanted patients (heart failure, 15.8±4.1; implanted, 19.8±5.8; explanted, 28.2±5.0 ml.kg-1.min-1; p<0.05) as was anaerobic threshold (heart failure, 11.2±1.9; implanted, 14.7±4.9; explanted, 21.4±5.0 ml.kg-1.min-1; p<0.05). In conclusion, peak CPO differentiates well during cardiac restoration using LVADs and emphasizes the benefits of this therapy. CPO has the potential to be a key physiological marker of heart failure severity and can guide management of LVAD patients.


Publication metadata

Author(s): Jakovljevic DG, George RS, Donovan G, Nunan D, Henderson K, Bougard RS, Yacoub MH, Birks EJ, Brodie DA

Publication type: Article

Publication status: Published

Journal: The American Journal of Cardiology

Year: 2010

Volume: 105

Issue: 12

Pages: 1780-1785

Print publication date: 15/06/2010

ISSN (print): 0002-9149

ISSN (electronic): 1879-1913

Publisher: Excerpta Medica, Inc.

URL: http://dx.doi.org/10.1016/j.amjcard.2010.01.362

DOI: 10.1016/j.amjcard.2010.01.362


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