Over the last years, left ventricular assist devices (LVADs) have become a possible destination therapy for patients with advanced heart failure (HF). According to heart transplant guidelines, exercise performance is a major parameter in the decision‐making process. Cardiopulmonary exercise test (CPET) is the gold standard for exercise evaluation in HF. At present, however, there is a lack of evidence on the contribution of LVAD in improving exercise capacity as measured by CPET, since in many cases a complete CPET may not be performed in the pre‐LVAD evaluation and/or a maximal effort is considered too demanding – if not dangerous – for severe HF patients. Exercise capacity before and after LVAD has been investigated in few reports analysing a very limited number of cases, and, moreover, data are contradictory; indeed, some authors reported that exercise capacity remains severely reduced, while others found a substantial increase in peak oxygen uptake (VO2) and in overall exercise performance. With the aim of analysing the effect of LVAD on exercise performance, we evaluated the CPETs of 15 consecutive patients who had CPET during pre‐LVAD evaluations and underwent a successful continuous‐flow LVAD implantation as a destination therapy.
Trombara F, Apostolo A, Vignati C, Naliato M, Ceriani R, Agostoni P. Effects of left ventricular assist device on cardiopulmonary exercise performance. Eur J Heart Fail 2019 Dec 21. doi: 10.1002/ejhf.1680.