Fresiello Libera, Buys Roselien, Jacobs Steven, Van Puyvelde Joeri, Droogne Walter, Rega Filip, Meyns Bart
1 Department of Clinical Cardiac Surgery, Katholieke Universiteit Leuven, Belgium.
2 Institute of Clinical Physiology, National Research Council, Italy.
Eur J Prev Cardiol. 2017 Jan;24(2):168-177. doi: 10.1177/2047487316656088. Epub 2016 Jul 10.
Background In the present work, we investigated the exercise capacities of patients with partial flow left ventricular assist devices and its evolution over time. We then compared the exercise capacities of these patients with those of full support ventricular assist device patients. Methods We retrospectively analysed the data of maximal cardiopulmonary exercise tests of ten partial support patients (CircuLite Synergy® Micropump) collected before (PS0), at 3 (PS3) and 6 months (PS6) after implantation. The data were then compared with those of 17 patients (FS6) treated with a full support device (HeartMate II, Thoratec©). For this analysis, we considered the exercise tests performed at 6 months after pump implantation for both groups. Results Peak oxygen uptake evolved in the PS0, PS3 and PS6 groups from 11.5 ± 2.3 to 12.6 ± 2.8 and 12.0 ± 2.7 mL/kg/min, respectively. Heart rate peak increased from PS0 to PS6 (100 ± 17 bpm and 107 ± 22 bpm, p = 0.05). The comparative analysis between PS6 and FS6 groups showed no difference in terms of exercise performance (12.0 ± 2.7 and 13.5 ± 3.0 mL/kg/min, respectively), fatigue perception, ventilation efficiency slope, anaerobic threshold and oxygen uptake efficiency slope. The chronotropic response was also similar in both PS6 and FS6 groups. However, PS6 patients were more often treated with β-blockers and therefore had lower heart rates at rest and at peak exercise than FS6 patients. Conclusions Exercise performance does not change after partial support implantation and stays stable over time. Partial and full support patients show similar exercise performances that attain 41% and 46% of the expected values, respectively.
背景 在本研究中，我们调查了使用部分流量左心室辅助装置患者的运动能力及其随时间的变化。然后，我们将这些患者的运动能力与完全支持心室辅助装置患者的运动能力进行了比较。方法 我们回顾性分析了10例部分支持患者（CircuLite Synergy®微型泵）在植入前（PS0）、植入后3个月（PS3）和6个月（PS6）收集的最大心肺运动试验数据。然后将这些数据与17例接受完全支持装置（HeartMate II，Thoratec©）治疗的患者（FS6）的数据进行比较。对于此分析，我们考虑了两组在泵植入后6个月进行的运动试验。结果 PS0、PS3和PS6组的峰值摄氧量分别从11.5±2.3升高至12.6±2.8和12.0±2.7 mL/kg/min。心率峰值从PS0增加到PS6（分别为100±17次/分钟和107±22次/分钟，p = 0.05）。PS6组和FS6组之间的比较分析显示，在运动表现（分别为12.0±2.7和13.5±3.0 mL/kg/min）、疲劳感知、通气效率斜率、无氧阈值和摄氧量效率斜率方面没有差异。两组的变时性反应也相似。然而，PS6组患者更常接受β受体阻滞剂治疗，因此与FS6组患者相比，静息和运动峰值时的心率更低。结论 部分支持植入后运动表现不变，且随时间保持稳定。部分支持和完全支持患者的运动表现相似，分别达到预期值的41%和46%。
