Exercise Therapy in Patients with Left-Ventricular Assist Device (LVAD)



Year of publication 2021
Type Article in Proceedings
Conference Noninvasive methods in cardiology 2021
MU Faculty or unit

Faculty of Medicine

Web https://is.muni.cz/do/med/noninvasive_methods_in_cardiology/Noninvasive_methods_in_cardiology_2021.pdf
Keywords left-ventricular assist device; heart failure; exercise training; rehabilitation; functional fitness
Description Background. Thanks to technological progress, left-sided mechanical cardiac supports (LVADs) are nowadays a frequent alternative to heart transplantation. Thanks to LVAD, patients in the end-stage of chronic heart failure (CHF) have a significant improvement in their health. However, the degree of improvement is limited, and therefore, increased attention is paid to the possibilities of increasing functional fitness through regular physical activity. Patients and methods. Twenty six patients (all M; mean age 58 ± 5.7 yrs) with terminal stage of CHF, were enrolled in the project. Two types of LVADs were implanted: HeartWare® (n = 14) and HeartMate3® (n = 12). At discharge, all patients were asked to perform physical activity at home for at least 60 min / day (recommended was low-to-moderate intensity aerobic training, such as walking and stationary or light cycling). The 6-minutes corridor walk-test (6CWT) was done for the assessment of the functional capacity and the European Quality of Life Questionnaire - Version 5D (EQ-5D) was used for the evaluation of the quality of life (QoL). The testing was realized before LVAD implantation, at discharge, after 3, 6 and 12 months. Results. Only 12 patients were able to complete the 6CWT before implantation (the mean distance walked was 283 ± 94.5m). At discharge, all the 26 patients underwent the 6CWT test (distance walked was 299 ± 67.1m; P <0.05). After 3 months, 16 patients achieved the 6CWT (distance walked was 396 ± 80.7m; P <0.001); after 6 months, 14 patients attended the 6CWT (distance walked was 391 ± 111.8m; P <0.001); and after 12 months only 8 patients were tested (distance walked was 366 ± 132.2m; P <0.001). Similar results were obtained from the evaluation of the EQ-5D questionnaire, which showed a significant improvement in mean values from 54.9 ± 19.7% at baseline to 71.1 ± 16.1% at discharge (P <0.01); 75.7 ± 19.7% after 3 months (P <0.01); 78.6 ± 14.9% after 6 months (P <0.01); and at 62.8 ± 24.3% (P <0.04) after 1 year from the LVAD implantation. Conclusion. Despite a number of limitations, especially the declining number of patients during long-term follow-up, the results obtained clearly confirm a significant improvement in submaximal physical activities and the quality of life of patients with implanted LVAD.

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