Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
ISSN: 2155-9880
Hitoshi Adachi
Gunma Prefectural Cardiovascular Center, Japan
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Background & Aim: Left ventricular assist devise (LVAD) is well known to improve cardiac function of patients with severe heart failure. It is applied to patients whose peak oxygen uptake is extremely decreased. However, we sometimes experience patients whose exercise tolerance does not improve sufficiently although LVAD is successfully implanted. We hypothesized that this is because LVAD can improve only cardiac output, and exercise tolerance is regulated not only by cardiac function but also by skeletal muscle function. Hereby, we examined which parameter of cardiopulmonary exercise test (CPX) is improved by LVAD activation. Methodology: A forty-three year-old man with dilated cardiomyopathy who was implanted extracorporeal LVAD performed CPX three times with 3 months interval. Between each CPX, patient performed exercise training. Each times, CPX was repeated twice. At first, it was performed under a condition of effective LVAD assist (LVAD-on). Next, it was performed without effective assist (LVAD-off). We compared peak VO2 and nadir VE/VCO2. Results: From the 1st CPX to the 3rd CPX, both peak VO2 and VE/VCO2 improved gradually. As for the effect of LVAD assist, VE/VCO2 was lower when LVAD is effective, while peak VO2 showed no difference between LVAD-on and off. Conclusions: Exercise training improved peak VO2 in DCM (Dilated Cardiomyopathies) patient, however, increase of cardiac output by LVAD failed to improve peak VO2. Cardiac rehabilitation was revealed necessary to improve the exercise tolerance.