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ISRN Cardiology
Volume 2012 (2012), Article ID 907102, 5 pages
http://dx.doi.org/10.5402/2012/907102
Clinical Study

Ischemic Time as a Predictor of Physical Recovery in the First Months after Heart Transplantation

1Heart Failure and Transplant Unit, La Fe University Hospital, Boulevar Sur S/N, 46026 Valencia, Spain
2Cardiology Department, La Fe University Hospital, Boulevar Sur S/N, 46026 Valencia, Spain
3Research Institute, La Fe University Hospital, Boulevar Sur S/N, 46026 Valencia, Spain
4Arrhythmology and Electrophysiology Department, La Fe University Hospital, Boulevar Sur S/N, 46026 Valencia, Spain

Received 29 March 2012; Accepted 8 May 2012

Academic Editors: P. R. Hansen and F. Quaini

Copyright © 2012 Francisco Buendía-Fuentes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Functional results after heart transplantation range from modest to spectacular improvement. Little is known about factors to predict functional result. This study aimed to identify these factors. We present a prospective study including all consecutive transplant recipients ( 𝑛 = 5 5 ) in a two-year period whose survival was greater than two months. Perioperative, donor, and recipient issues were systematically analyzed. Exercise capacity was assessed by symptom-limited treadmill exercise testing two months after transplantation. Exercise capacity was classified as satisfactory or poor depending on achieving or not 4.5 METs (metabolic equivalents), respectively. Thirty-three patients (60%) showed a good exercise capacity (>4.5 METs), whereas the remaining twenty-two patients (40%) were unable to exceed this threshold. The variables which correlated with exercise capacity in univariate analysis were recipient age, inotropic treatment, ischemic time, ventricular assist device, etiology, urgent transplant, and INTERMACS score. Among them only recipient age and ischemic time were proved to be correlated with exercise capacity in the multiple regression analysis. Thus, younger patients and those who had received an organ with shorter ischemic time showed greater exercise capacity after transplant. These findings strengthen the trend toward reducing ischemic time as much as possible to improve both survival and clinical recovery.