Peripheral adaptation mechanisms in physical training and cardiac rehabilitation: the case of a patient supported by a CardioWest total artificial heart

J Card Fail. 2011 Aug;17(8):670-5. doi: 10.1016/j.cardfail.2011.04.006. Epub 2011 May 28.

Abstract

Background: The benefits of exercise training in patients with chronic heart failure (CHF) are due to a combination of cardiac and peripheral adaptations. Separating these 2 components is normally impossible, except for patients implanted with total artificial heart (TAH), where cardiac adaptation cannot occur.

Methods and results: We report the case of a patient implanted with a CardioWest-TAH who underwent a comprehensive strength and endurance training program and was evaluated by repeated peak cardiopulmonary exercise tests. The patient experienced a 24% increase of peak oxygen consumption and an improvement in recovery kinetics during the training period of 29 months.

Conclusion: This unique situation of a patient with a TAH, and therefore a fixed peak cardiac output, allows us to isolate training-induced changes in the periphery, that suggest greater oxygen extraction and more efficient metabolic gas kinetics during the exercise and recovery phases.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological / physiology*
  • Exercise Therapy / methods*
  • Heart Failure / physiopathology
  • Heart Failure / rehabilitation*
  • Heart Failure / surgery
  • Heart, Artificial*
  • Hospitalization*
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged