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Canadian Respiratory Journal
Volume 4, Issue 2, Pages 81-87
Original Article

Changes in the Cardiopulmonary Response to Exercise after Cardiac Transplantation in Patients Enrolled in an Early Rehabilitation Program

Lizanne M Bussières,1 Peter W Pflugfelder,2 Albert W Taylor,3 Dildar Ahmad,4 Corinne Weernink,5 and William J Kostuk6

1Faculty of Kinesiology, The University of Western Ontario, London, Ontario, Canada
2Divisions of Cardiology, The University of Western Ontario, London, Ontario, Canada
3Division of Respiratory Medicine, The University of Western Ontario, London, Ontario, Canada
4Division of Physiotherapy, The University of Western Ontario, London, Ontario, Canada
5Department of Medicine, The University of Western Ontario, London, Ontario, Canada
6University Hospital, London, Ontario, Canada

Copyright © 1997 Hindawi Publishing Corporation. 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.


OBJECTIVE: To evaluate the changes in the cardiopulmonary response to exercise in the first year after cardiac transplantation in patients enrolled in a rehabilitation program in the first three months post-transplantation.

METHODS: A graded cycle exercise test with mixed expired gas analysis was performed on patients with end-stage cardiac failure before and serially after cardiac transplantation at one, three and 12 months.

RESULTS: Before cardiac transplantation, seven patients were fit enough to be tested. They had a low peak oxygen uptake (VO2 max) and a blunted heart rate and blood pressure response to exercise. They also displayed a restrictive pattern of ventilation during exercise. At three months following transplantation, patients (n=19) had a significantly higher VO2 max (19.9±5.3 versus 9.8±1.4 mL/kg/min, P<0.05), higher peak systolic blood pressure (177±22 versus 94±18 mmHg, P<0.05), greater peak minute ventilation (70±23 versus 34±5 L/min, P<0.05) and lower slope of minute ventilation to carbon dioxide output (35.4±6.2 versus 45.1±6.7, P<0.05) than before transplantation. The VO2 max measured at 12 months post-transplant was similar to the three month value and was on average equal to 59% of the predicted value.

CONCLUSIONS: These results indicate that there is a rapid and marked improvement in exercise capacity in patients following cardiac transplantation. These changes are associated with significant respiratory and cardiovascular adaptations. However, despite the marked improvement in exercise capacity, the VO2 max of cardiac transplant recipients enrolled in an early rehabilitation program did not return to normal at 12 months after surgery.