Lvad pump speed increase is associated with increased peak exercise cardiac output and vo 2 , postponed anaerobic threshold and improved ventilatory efficiency

Peak exercise cardiac output (CO) increase is associated with an increase of peak oxygen uptake (VO ), provided that arteriovenous O difference [Δ(Ca-Cv)O ] does not decrease. At anaerobic threshold, VO , is related to CO. We tested the hypothesis that, in heart failure (HF) patients with left ventr...

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Bibliographic Details
Published in:International journal of cardiology 2017-03, Vol.230, p.28
Main Authors: Vignati, Carlo, Apostolo, Anna, Cattadori, Gaia, Farina, Stefania, Del Torto, Alberico, Scuri, Silvia, Gerosa, Gino, Bottio, Tomaso, Tarzia, Vincenzo, Bejko, Jonida, Sisillo, Erminio, Nicoli, Flavia, Sciomer, Susanna, Alamanni, Francesco, Paolillo, Stefania, Agostoni, Piergiuseppe
Format: Article
Language:English
Subjects:
Anaerobic Threshold - physiology
Cardiac Output - physiology
Cross-Over Studies
Double-Blind Method
Exercise
Female
Heart Failure - physiopathology
Heart Failure - therapy
Heart-Assist Devices
Humans
Male
Middle Aged
Oxygen Consumption - physiology
Pulmonary Gas Exchange - physiology
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Summary:Peak exercise cardiac output (CO) increase is associated with an increase of peak oxygen uptake (VO ), provided that arteriovenous O difference [Δ(Ca-Cv)O ] does not decrease. At anaerobic threshold, VO , is related to CO. We tested the hypothesis that, in heart failure (HF) patients with left ventricular assistance device (LVAD), an acute increase of CO obtained through changes in LVAD pump speed is associated with peak exercise and anaerobic threshold VO increase. Fifteen of 20 patients bearing LVAD (Jarvik 2000) enrolled in the study successfully performed peak exercise evaluation. All patients had severe HF as shown by clinical evaluation, laboratory tests, echocardiography, spirometry with alveolar-capillary diffusion, and maximal cardiopulmonary exercise testing (CPET). CPETs with non-invasive CO measurements at rest and peak exercise were done on 2days at LVAD pump speed set randomly at 2 and 4. Increasing LVAD pump speed from 2 to 4 increased CO from 3.4±0.9 to 3.8±1.0L/min (ΔCO 0.4±0.6L/min, p=0.04) and from 5.3±1.3 to 5.9±1.4L/min (ΔCO 0.6±0.7L/min, p
ISSN:1874-1754