Depressive symptoms, right ventricular function, and muscular strength are associated with peak oxygen uptake in patients with implantable left ventricular assist devices
Corresponding Author
Kazufumi Kitagaki
Faculty of Rehabilitation, Shijonawate Gakuen University, Daito, Japan
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Correspondence
Kazufumi Kitagaki, Faculty of Rehabilitation, Shijonawate Gakuen University, 5-11-10 Houjou Daito 574-0011, Osaka, Japan.
Email: [email protected]
Search for more papers by this authorTatsuo Aoki
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorHiroyuki Miura
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorYukihiro Shimada
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorHarumi Konishi
Department of Nursing, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorYasumasa Tsukamoto
Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorTeruo Noguchi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorCorresponding Author
Kazufumi Kitagaki
Faculty of Rehabilitation, Shijonawate Gakuen University, Daito, Japan
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Correspondence
Kazufumi Kitagaki, Faculty of Rehabilitation, Shijonawate Gakuen University, 5-11-10 Houjou Daito 574-0011, Osaka, Japan.
Email: [email protected]
Search for more papers by this authorTatsuo Aoki
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorHiroyuki Miura
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorYukihiro Shimada
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorHarumi Konishi
Department of Nursing, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorYasumasa Tsukamoto
Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorTeruo Noguchi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
Search for more papers by this authorAbstract
Background
Left ventricular assist device (LVAD) implantation is among the most effective treatment options for patients with severe heart failure. Although previous studies have examined the factors related to peak oxygen uptake (peak VO2), they were limited by the few patients involved and their focus on medical and physical functions. Therefore, this study comprehensively examined the factors associated with peak VO2, which is an important prognostic factor in patients with implantable LVADs.
Methods
Eighty-nine patients who underwent initial LVAD implantation and were eligible for cardiopulmonary exercise testing (CPX) between May 2014 and September 2021 were included. The patients' mean age was 48 ± 12 years, and 70% were males. Based on previous studies, the cut-off was set at 12 and 14 mL/kg/min for patients taking β-blocker and those not taking β-blockers, respectively. Furthermore, factors associated with peak VO2 were examined using multivariate logistic regression analysis.
Results
The mean time from surgery to CPX administration was 73 ± 40 days. The high group had a higher cardiac index, right ventricular stroke work index (RVSWI), and isometric knee extensor muscular strength and lower Patient Health Questionnaire-9 (PHQ-9) and B-type natriuretic peptide values than the low group. Multivariate logistic regression analysis showed that RVSWI and KEMS were positively correlated, whereas PHQ-9 was negatively associated with peak VO2.
Conclusion
Right ventricular function, depressive symptoms, and lower limb muscular strength were associated with exercise capacity in patients with implantable LVADs.
CONFLICT OF INTEREST STATEMENT
The authors have no financial conflicts of interest to disclose concerning the study.
Open Research
DATA AVAILABILITY STATEMENT
The data generated and/or analyzed during this research are available from the corresponding author upon reasonable request.
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