PMID- 31569116
OWN - NLM
STAT- MEDLINE
DCOM- 20201105
LR  - 20210125
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 66
IP  - 3
DP  - 2020 Mar
TI  - Left Ventricular Filling Pressures Contribute to Exercise Limitation in Patients 
      with Continuous Flow Left Ventricular Assist Devices.
PG  - 247-252
LID - 10.1097/MAT.0000000000001073 [doi]
AB  - We sought to determine hemodynamic mechanisms of exercise intolerance in a group 
      of patients with the HeartWare ventricular assist device (VAD) compared to a 
      group of heart failure patients. Twenty VAD and 22 heart failure patients 
      underwent symptom-limited active straight leg raising exercise during right heart 
      catheterization with thermodilution (TD), and upright cycling cardiopulmonary 
      stress testing with cardiac output measurement by inert gas rebreathing (IGR) 
      method. The TD and IGR exercise cardiac indexes were higher in VAD compared with 
      heart failure group (both P < 0.05), although there was only a borderline 
      increase in peak exercise oxygen consumption (VO2) (P = 0.06). Baseline and 
      exercise right heart catheterization pressures were not significantly different 
      between the two groups. The only significant independent predictors of peak VO2 
      in the heart failure group were exercise heart rate and cardiac index (both P < 
      0.05). In contrast, for the VAD group only, resting pulmonary arterial wedge and 
      pulmonary arterial mean pressures were independently related to peak VO2 (both P 
      < 0.05). Thus, in heart failure, exercise cardiac index is an important 
      limitation to exercise capacity, and VADs increase exercise cardiac index. 
      However, in VAD patients, this only produces limited benefits as increased 
      pulmonary and pulmonary wedge pressures limit increases in exercise capacity.
FAU - Koshy, Aaron
AU  - Koshy A
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Bouzas-Cruz, Noelia
AU  - Bouzas-Cruz N
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
AD  - University of Santiago de Compostela, Galicia, Spain.
FAU - Okwose, Nduka C
AU  - Okwose NC
AD  - Newcastle University Institutes of Cellular Medicine and Genetic Medicine, 
      Newcastle upon Tyne, United Kingdom.
FAU - Fernandez, Oscar Gonzalez
AU  - Fernandez OG
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Green, Thomas
AU  - Green T
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Woods, Andrew
AU  - Woods A
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Robinson-Smith, Nicola
AU  - Robinson-Smith N
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Tovey, Sian
AU  - Tovey S
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - McDiarmid, Adam
AU  - McDiarmid A
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Parry, Gareth
AU  - Parry G
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Schueler, Stephan
AU  - Schueler S
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
FAU - Jakovljevic, Djordje G
AU  - Jakovljevic DG
AD  - Newcastle University Institutes of Cellular Medicine and Genetic Medicine, 
      Newcastle upon Tyne, United Kingdom.
FAU - MacGowan, Guy A
AU  - MacGowan GA
AD  - From the Departments of Cardiology and Cardiothoracic Surgery, Freeman Hospital, 
      Newcastle upon Tyne, United Kingdom.
AD  - Newcastle University Institutes of Cellular Medicine and Genetic Medicine, 
      Newcastle upon Tyne, United Kingdom.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Adult
MH  - Aged
MH  - Exercise/*physiology
MH  - Female
MH  - Heart Failure/*physiopathology
MH  - *Heart-Assist Devices
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Oxygen Consumption/physiology
MH  - Ventricular Function, Left/*physiology
EDAT- 2019/10/01 06:00
MHDA- 2020/11/06 06:00
CRDT- 2019/10/01 06:00
PHST- 2019/10/01 06:00 [pubmed]
PHST- 2020/11/06 06:00 [medline]
PHST- 2019/10/01 06:00 [entrez]
AID - 00002480-202003000-00002 [pii]
AID - 10.1097/MAT.0000000000001073 [doi]
PST - ppublish
SO  - ASAIO J. 2020 Mar;66(3):247-252. doi: 10.1097/MAT.0000000000001073.