LVAD Patients More Active, Fit Than Counterparts With Heart Failure

By Reuters Staff

August 10, 2019

NEW YORK (Reuters Health) - Patients with left ventricular assist devices (LVAD) are more physically active than matched patients with advanced chronic heart failure (CHF), and have higher peak oxygen consumption (VO2 peak), according to new findings.

"These findings support that LVAD implantation is important in the functional rehabilitation of patients with advanced CHF," Dr. Ignacio Moreno-Suarez of Curtin University in Perth, Australia, and colleagues write in Medicine and Science in Sports and Exercise, online July 24.

LVADs are increasingly being used as "destination therapy" for advanced CHF patients, and not as a bridge to eventual cardiac transplant, the authors note. The devices improve survival and also increase exercise tolerance, but it's unclear if they increase daily physical activity (PA).

"Of particular importance is whether PA is higher in a cohort of patients with LVADs beyond the initial post-implantation period, compared with patients with CHF," they write.

To investigate, the authors compared 16 patients with LVADs to 16 advanced CHF patients matched by age, sex and pre-LVAD New York Heart Association functional class.

Before implantation, average VO2 peak was not significantly different between the pre-LVAD patients and the advanced CHF patients, at 12.3 and 10.4 mL/kg/min, respectively.

After implantation, the LVAD group's average V02 peak was 15.8 mL/kg/min, which was significantly higher than in CHF patients.

The LVAD group averaged 19.7 kJ/kg per day, versus 11.6 kJ/kg per day in the control group (P=0.001). They engaged in a median of 26 minutes of moderate-intensity PA per day versus 12 minutes for the advanced CHF patients (P=0.001), although levels of light and vigorous PA were similar in both groups.

Forty-four percent of the LVAD group engaged in brief bouts of intensive activity, versus 19% of the CHF group. LVAD patients had 1,294 total minutes of sedentary time per day (including sleeping), versus 1,329 minutes for the CHF group.

In both groups, PA was significantly correlated with VO2 peak. LVAD patients also reported better health-related quality of life.

"The improved functional capacity evident in patients with LVADs is likely to translate to an enhanced ability to participate more actively in rehabilitative exercise programs and engage in activities of daily living with less symptoms, important clinical objectives in both patients with advanced CHF being bridged to cardiac transplantation, or on long-term LVAD support," the authors conclude.

SOURCE: https://bit.ly/2M8jxi7

Med Sci Sports Exerc 2019.

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