Accepted Manuscript Changes in Cardiopulmonary Exercise Testing Parameters Following Continuous Flow Left Ventricular Assist Device Implantation and Heart Transplantation Shannon M. Dunlay , MD, MS Thomas G. Allison , PhD, MPH Naveen L. Pereira , MD PII:
S1071-9164(14)00213-9
DOI:
10.1016/j.cardfail.2014.05.008
Reference:
YJCAF 3304
To appear in:
Journal of Cardiac Failure
Received Date: 6 January 2014 Revised Date:
4 April 2014
Accepted Date: 22 May 2014
Please cite this article as: Dunlay SM, Allison TG, Pereira NL, Changes in Cardiopulmonary Exercise Testing Parameters Following Continuous Flow Left Ventricular Assist Device Implantation and Heart Transplantation, Journal of Cardiac Failure (2014), doi: 10.1016/j.cardfail.2014.05.008. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Changes in Cardiopulmonary Exercise Testing Parameters Following Continuous Flow Left Ventricular Assist Device Implantation and Heart Transplantation
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Shannon M. Dunlay MD MS*†, Thomas G. Allison PhD MPH*, Naveen L. Pereira MD* From the *Division of Cardiovascular Diseases in the Department of Internal Medicine and the †Division of Health Care Policy and Research in the Department of Health Sciences Research, Mayo Clinic,
SC
Rochester MN
M AN U
Brief Title: Changes in Exercise Testing after LVAD and Heart Transplant
Contact Author Information: Shannon M. Dunlay, 200 First St SW, Rochester MN 55905; Phone 507284-8087, Fax 507-266-7929, Email: [email protected]
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Funding Sources. Dr. Dunlay is funded by a National Institutes of Health Career Development Award (K23HL 116643). Dr. Pereira is funded by a grant from the National Center for Advancing Translational
EP
Sciences (UL1 TR000135).
Tables: 3 Figures: 2
AC C
Word Count: 3236 (Introduction through Discussion)
ACCEPTED MANUSCRIPT
ABSTRACT Background: Reduced exercise tolerance from impaired cardiac output is an important criterion for left
RI PT
ventricular assist device (LVAD) implantation. However, little is known about how exercise capacity changes following LVAD, and how changes compare with patients undergoing heart transplant.
Methods and Results: We compared changes in cardiopulmonary exercise testing performed pre- and post-operatively in patients who underwent HeartMate II LVAD implantation (n=25) and heart
SC
transplantation (n=74) at the Mayo Clinic in Rochester, Minnesota from 2007-2012. Pre-operatively, patients undergoing LVAD and transplant had markedly reduced exercise time (mean 5.1 minutes [45%
M AN U
predicted] and 5.0 minutes [44% predicted], respectively), low peak VO2 (mean 11.5 ml/kg/min [43% predicted] and 11.9 mL/kg/min [38% predicted]), and abnormal ventilatory gas exchange (VE/VCO2 nadir 39.4 and 37.4). Following LVAD and transplant, there were similar improvements in exercise time (mean ∆ +1.2 vs. 1.7 minutes, respectively, p=0.27) and VE/VCO2 nadir (mean ∆ -3.7 vs. -4.2, p=0.74). However,
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peak VO2 increased post-transplant but did not change post-LVAD (mean ∆+5.4 vs. +0.9mL/kg/min, respectively, p
S1071-9164(14)00213-9
DOI:
10.1016/j.cardfail.2014.05.008
Reference:
YJCAF 3304
To appear in:
Journal of Cardiac Failure
Received Date: 6 January 2014 Revised Date:
4 April 2014
Accepted Date: 22 May 2014
Please cite this article as: Dunlay SM, Allison TG, Pereira NL, Changes in Cardiopulmonary Exercise Testing Parameters Following Continuous Flow Left Ventricular Assist Device Implantation and Heart Transplantation, Journal of Cardiac Failure (2014), doi: 10.1016/j.cardfail.2014.05.008. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Changes in Cardiopulmonary Exercise Testing Parameters Following Continuous Flow Left Ventricular Assist Device Implantation and Heart Transplantation
RI PT
Shannon M. Dunlay MD MS*†, Thomas G. Allison PhD MPH*, Naveen L. Pereira MD* From the *Division of Cardiovascular Diseases in the Department of Internal Medicine and the †Division of Health Care Policy and Research in the Department of Health Sciences Research, Mayo Clinic,
SC
Rochester MN
M AN U
Brief Title: Changes in Exercise Testing after LVAD and Heart Transplant
Contact Author Information: Shannon M. Dunlay, 200 First St SW, Rochester MN 55905; Phone 507284-8087, Fax 507-266-7929, Email: [email protected]
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Funding Sources. Dr. Dunlay is funded by a National Institutes of Health Career Development Award (K23HL 116643). Dr. Pereira is funded by a grant from the National Center for Advancing Translational
EP
Sciences (UL1 TR000135).
Tables: 3 Figures: 2
AC C
Word Count: 3236 (Introduction through Discussion)
ACCEPTED MANUSCRIPT
ABSTRACT Background: Reduced exercise tolerance from impaired cardiac output is an important criterion for left
RI PT
ventricular assist device (LVAD) implantation. However, little is known about how exercise capacity changes following LVAD, and how changes compare with patients undergoing heart transplant.
Methods and Results: We compared changes in cardiopulmonary exercise testing performed pre- and post-operatively in patients who underwent HeartMate II LVAD implantation (n=25) and heart
SC
transplantation (n=74) at the Mayo Clinic in Rochester, Minnesota from 2007-2012. Pre-operatively, patients undergoing LVAD and transplant had markedly reduced exercise time (mean 5.1 minutes [45%
M AN U
predicted] and 5.0 minutes [44% predicted], respectively), low peak VO2 (mean 11.5 ml/kg/min [43% predicted] and 11.9 mL/kg/min [38% predicted]), and abnormal ventilatory gas exchange (VE/VCO2 nadir 39.4 and 37.4). Following LVAD and transplant, there were similar improvements in exercise time (mean ∆ +1.2 vs. 1.7 minutes, respectively, p=0.27) and VE/VCO2 nadir (mean ∆ -3.7 vs. -4.2, p=0.74). However,
TE D
peak VO2 increased post-transplant but did not change post-LVAD (mean ∆+5.4 vs. +0.9mL/kg/min, respectively, p
