Abstract 1539: Benefits of Chronic Exercise Training on Aerobic Capacity and NT-proBNP Plasma Levels in Patients With Ventricular Assist Devices
Introduction: Patients supported with ventricular assist devices are increasing and tend to stay longer on mechanical support. Studies show a maximal benefit on aerobic capacity 12 weeks post-implantation.
Hypothesis: We hypothesized that patients could benefit with exercise training even long term post-implantation.
Methods: Twelve patients, age 33.6±14 yrs, implanted with Left Ventricular Assist Device (LVAD) or BiVentricular Assist Device (BiVAD) (BerlinHeart) as a bridge to heart transplantation were randomly assigned, at a ratio 2/1, in a training group (TG) (n=8/LVAD=4, BiVAD=4) or a control group (CG) (n=4/LVAD=2, BiVAD=2), 6.2±4.1 months post-implantation. Training involved 10- week home aerobic exercise using a stationary bike for 45 min, at an intensity 12–14 of Borg scale, 3–5/week as well as advice for everyday walk for 30 – 45 min. Patients also underwent high-intensity inspiratory muscle training (IMT) using a computer-designed software (TRAINAIR) at 60% of sustained maximal inspiratory pressure (SPimax) to respiratory exhaustion, 2–3/week inhospital. CG was only advised for everyday walk for 30 – 45 minutes. Both groups were evaluated for exercise capacity using cardiopulmonary exercise testing and the 6-min walk test (6MWT). Pulmonary function was tested by spirometry and dyspnea by the Borg scale at the end of the 6MWT. Plasma NT-proBNP levels were also measured.
Results: TG improved inspiratory muscle strength (Pimax, 144±21.6 vs. 105.3±21.6 cmH2O, p=0.01), endurance (SPimax, 530±384 vs. 384±190 cmH2O/s/1000) and inspiratory lung capacity (2.5±0.9 vs. 1.8±0.8 L, p=0.01). Peak oxygen consumption improved (20.3±4.6 vs. 17.9±3.2 ml/kg/min p=0.03) and the ventilatory equivalent VE/VCO2 dropped (35.1±5.4 vs. 39.3±6.4, p=0.02). The 6MWT distance increased (553.7±54 vs. 493.7±52 m, p=0.01) while dyspnea did not change significantly. Plasma NT-proBNP levels decreased post-training (995.6±477 vs. 1293±477 pg/ml, p=0.03). No significant changes in pulmonary function, exercise capacity, dyspnea or NT-proBNP levels were noted in the CG.
Conclusions: Our findings indicate the benefits of exercise training even long-term after device implantation and may have additional importance in cases of destination therapy.