Circulation, Vol 77, 162-171, Copyright © 1988 by American Heart Association
T Kavanagh, MH Yacoub, DJ Mertens, J Kennedy, RB Campbell and P Sawyer
We have tested the feasibility and effectiveness of a 2 year (average 16
+/- 7 months) walk/jog exercise program on 36 male orthotopic cardiac
transplant patients (21 to 57 years old) seen initially 2 to 23 months
after surgery. Comparison of initial exercise test results with those in 45
age-matched normal men showed the patients to have a lesser lean body mass
(56 +/- 7 vs 63 +/- 8 kg, p less than .001), with a higher resting heart
rate (104 +/- 12 vs 77 +/- 14 beats/min, p less than .001) and systolic
(138 +/- 16 vs 129 +/- 17 mm Hg, p less than .001) and diastolic (95 +/- 14
vs 84 +/- 10 mm Hg, p less than .001) blood pressures. Peak power output
was less than normal (101 +/- 27 vs 219 +/- 41 W, p less than .001), as was
peak heart rate (136 +/- 15 vs 176 +/- 13 beats/min, p less than .001),
peak oxygen intake (VO2max) (22 +/- 5 vs 34 +/- 6 ml.kg.min-1, p less than
.001), and absolute anaerobic threshold (1.18 +/- 0.40 vs 2.04 +/- 0.40
liters.min-1, p less than .001). Peak ventilatory equivalent was higher (48
+/- 9 vs 37 +/- 61.1-1, p less than .001). Cardiac output (Q), as estimated
by the CO2 rebreathing method, was slightly above normal at rest (p less
than .01), but below normal at two submaximal work rates. The group's
average weekly training distance was 24 km, with eight highly compliant
patients progressing to 32 km or more weekly. After training, lean tissue
increased (+2.4 +/- 3.1 kg, p less than .001), and resting values were
reduced for heart rate (-4 +/- 11 beats/min, p less than .05), systolic
(-13 +/- 20 mm Hg, p less than .001), and diastolic (-9 +/- 17 mm Hg, p
less than .001) blood pressures. There were significant reductions in
submaximal values for minute ventilation (VE), ratings of perceived
exertion, and diastolic blood pressure at equivalent workloads. Peak values
increased for power output (+49 +/- 34 W, p less than .001), VO2max (+4.0
+/- 6.0 ml.kg.min-1, p less than .001), VE (+20 +/- 20 l.min-1, p less than
.001), and heart rate (+13 +/- 17 beats/min, p less than .001), and
decreased for diastolic blood pressure (-8 +/- 15 mm Hg, p less than
.001).(ABSTRACT TRUNCATED AT 400 WORDS)
ARTICLES
Cardiorespiratory responses to exercise training after orthotopic cardiac transplantation
Toronto Rehabilitation Centre, Ontario, Canada.
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