ArticlePloS one2020
Limiting factors of peak and submaximal exercise capacity in LVAD patients.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 23 citations in OpenAlex.
- Cardiac Rehabilitation After Left Ventricular Assist Device Implantation: A Narrative Review.Journal of clinical medicine · 2026Review
- Exercise and cardiac rehabilitation after LVAD implantation.Heart failure reviews · 2025Review
- Increased Dead Space Ventilation as a Contributing Factor to Persistent Exercise Limitation in Patients with a Left Ventricular Assist Device.Journal of clinical medicine · 2023Article
- LVAD as a Bridge to Remission from Advanced Heart Failure: Current Data and Opportunities for Improvement.Journal of clinical medicine · 2022Review
- Initial clinical validation of a hybridFrontiers in physiology · 2022Article
- Exercise Dynamic of Patients with Chronic Heart Failure and Reduced Ejection Fraction.Current cardiology reports · 2021Review
- Exercise physiology in left ventricular assist device patients: insights from hemodynamic simulations.Annals of cardiothoracic surgery · 2021Review
- The left ventricular assist device as a patient monitoring system.Annals of cardiothoracic surgery · 2021Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsAlthough patients supported with a Continuous-Flow Left Ventricular Assist Device (CF-LVAD) are hemodynamically stable, their exercise capacity is limited. Hence, the aim of this work was to investigate the underlying factors that lead to peak and submaximal exercise intolerance of CF-LVAD supported patients.
methodsSeven months after CF-LVAD implantation, eighty three patients performed a maximal cardiopulmonary exercise test and a six minute walk test. Peak oxygen uptake and the distance walked were measured and expressed as a percentage of the predicted value (%VO2p and %6MWD, respectively). Preoperative conditions, echocardiography, laboratory results and pharmacological therapy data were collected and a correlation analysis against %VO2p and %6MWD was performed.
resultsCF-LVAD patients showed a relatively higher submaximal exercise capacity (%6MWD = 64±16%) compared to their peak exertion (%VO2p = 51±14%). The variables that correlated with %VO2p were CF-LVAD parameters, chronotropic response, opening of the aortic valve at rest, tricuspid insufficiency, NT-proBNP and the presence of a cardiac implantable electronic device. On the other hand, the variables that correlated with %6MWD were diabetes, creatinine, urea, ventilation efficiency and CF-LVAD pulsatility index. Additionally, both %6MWD and %VO2p were influenced by the CF-LVAD implantation timing, calculated from the occurrence of the cardiac disease.
conclusionOverall, both %6MWD and %VO2p depend on the duration of heart failure prior to CF-LVAD implantation. %6MWD is primarily determined by parameters underlying the patient's general condition, while %VO2p mostly relies on the residual function and chronotropic response of the heart. Moreover, since %VO2p was relatively lower compared to %6MWD, we might infer that CF-LVAD can support submaximal exercise but is not sufficient during peak exertion. Hence concluding that the contribution of the ventricle is crucial in sustaining hemodynamics at peak exercise.
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