Effect of increasing pump speed during exercise on peak oxygen uptake in heart failure patients supported with a continuous-flow left ventricular assist device. A double-blind randomized study

Mette Holme Jung, Peter Bo Hansen, Kaare Sander, Peter Skov Olsen, Kasper Rossing, Soeren Boesgaard, Stuart D. Russell, Finn Gustafsson

Research output: Contribution to journalArticle

Abstract

Aims Continuous-flow left ventricular assist device (CF-LVAD) implantation is associated with improved quality of life, but the effect on exercise capacity is less well documented. It is uncertain whether a fixed CF-LVAD pump speed, which allows for sufficient circulatory support at rest, remains adequate during exercise. The aim of this study was to evaluate the effects of fixed versus incremental pump speed on peak oxygen uptake (peak VO2) during a maximal exercise test. Methods and results In CF-LVAD (HeartMate II) patients exercise testing measuring peak oxygen uptake (VO2) was performed on an ergometer bike twice in one day: once with fixed pump speed (testfix) and once with incremental pump speed (testinc). The order of testfix and testinc in each patient was determined by randomization. During testinc pump speed was increased from the baseline value by 400 rpm/2 min. Fourteen patients (aged 23-69 years) were included with a mean support duration of 465 ± 483 days. Baseline CF-LVAD speed was 9357 ± 238 rpm and during testinc speed was increased by a mean of 1486 ± 775 rpm. Mean peak VO2 was significantly higher in testinc compared with testfix (15.4 ± 5.9 mL/kg/min vs. 14.1 ± 6.3 mL/kg/min; P = 0.012), corresponding to a 9.2% increase. All exercise tests (n = 28) were adequately performed with RER > 1. Conclusion Increasing pump speed during exercise augments peak VO2 in patients supported with CF-LVADs. An automatic speed-change function in future generations of CF-LVADs might improve functional capacity.

Original languageEnglish (US)
Pages (from-to)403-408
Number of pages6
JournalEuropean Journal of Heart Failure
Volume16
Issue number4
DOIs
StatePublished - 2014

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Heart-Assist Devices
Double-Blind Method
Heart Failure
Exercise
Oxygen
Exercise Test
Social Responsibility
Random Allocation
Quality of Life

Keywords

  • Heart failure
  • LVAD
  • Peak oxygen uptake
  • Ventricular assistance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Effect of increasing pump speed during exercise on peak oxygen uptake in heart failure patients supported with a continuous-flow left ventricular assist device. A double-blind randomized study. / Jung, Mette Holme; Hansen, Peter Bo; Sander, Kaare; Olsen, Peter Skov; Rossing, Kasper; Boesgaard, Soeren; Russell, Stuart D.; Gustafsson, Finn.

In: European Journal of Heart Failure, Vol. 16, No. 4, 2014, p. 403-408.

Research output: Contribution to journalArticle

Jung, Mette Holme ; Hansen, Peter Bo ; Sander, Kaare ; Olsen, Peter Skov ; Rossing, Kasper ; Boesgaard, Soeren ; Russell, Stuart D. ; Gustafsson, Finn. / Effect of increasing pump speed during exercise on peak oxygen uptake in heart failure patients supported with a continuous-flow left ventricular assist device. A double-blind randomized study. In: European Journal of Heart Failure. 2014 ; Vol. 16, No. 4. pp. 403-408.
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abstract = "Aims Continuous-flow left ventricular assist device (CF-LVAD) implantation is associated with improved quality of life, but the effect on exercise capacity is less well documented. It is uncertain whether a fixed CF-LVAD pump speed, which allows for sufficient circulatory support at rest, remains adequate during exercise. The aim of this study was to evaluate the effects of fixed versus incremental pump speed on peak oxygen uptake (peak VO2) during a maximal exercise test. Methods and results In CF-LVAD (HeartMate II) patients exercise testing measuring peak oxygen uptake (VO2) was performed on an ergometer bike twice in one day: once with fixed pump speed (testfix) and once with incremental pump speed (testinc). The order of testfix and testinc in each patient was determined by randomization. During testinc pump speed was increased from the baseline value by 400 rpm/2 min. Fourteen patients (aged 23-69 years) were included with a mean support duration of 465 ± 483 days. Baseline CF-LVAD speed was 9357 ± 238 rpm and during testinc speed was increased by a mean of 1486 ± 775 rpm. Mean peak VO2 was significantly higher in testinc compared with testfix (15.4 ± 5.9 mL/kg/min vs. 14.1 ± 6.3 mL/kg/min; P = 0.012), corresponding to a 9.2{\%} increase. All exercise tests (n = 28) were adequately performed with RER > 1. Conclusion Increasing pump speed during exercise augments peak VO2 in patients supported with CF-LVADs. An automatic speed-change function in future generations of CF-LVADs might improve functional capacity.",
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AU - Jung, Mette Holme

AU - Hansen, Peter Bo

AU - Sander, Kaare

AU - Olsen, Peter Skov

AU - Rossing, Kasper

AU - Boesgaard, Soeren

AU - Russell, Stuart D.

AU - Gustafsson, Finn

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N2 - Aims Continuous-flow left ventricular assist device (CF-LVAD) implantation is associated with improved quality of life, but the effect on exercise capacity is less well documented. It is uncertain whether a fixed CF-LVAD pump speed, which allows for sufficient circulatory support at rest, remains adequate during exercise. The aim of this study was to evaluate the effects of fixed versus incremental pump speed on peak oxygen uptake (peak VO2) during a maximal exercise test. Methods and results In CF-LVAD (HeartMate II) patients exercise testing measuring peak oxygen uptake (VO2) was performed on an ergometer bike twice in one day: once with fixed pump speed (testfix) and once with incremental pump speed (testinc). The order of testfix and testinc in each patient was determined by randomization. During testinc pump speed was increased from the baseline value by 400 rpm/2 min. Fourteen patients (aged 23-69 years) were included with a mean support duration of 465 ± 483 days. Baseline CF-LVAD speed was 9357 ± 238 rpm and during testinc speed was increased by a mean of 1486 ± 775 rpm. Mean peak VO2 was significantly higher in testinc compared with testfix (15.4 ± 5.9 mL/kg/min vs. 14.1 ± 6.3 mL/kg/min; P = 0.012), corresponding to a 9.2% increase. All exercise tests (n = 28) were adequately performed with RER > 1. Conclusion Increasing pump speed during exercise augments peak VO2 in patients supported with CF-LVADs. An automatic speed-change function in future generations of CF-LVADs might improve functional capacity.

AB - Aims Continuous-flow left ventricular assist device (CF-LVAD) implantation is associated with improved quality of life, but the effect on exercise capacity is less well documented. It is uncertain whether a fixed CF-LVAD pump speed, which allows for sufficient circulatory support at rest, remains adequate during exercise. The aim of this study was to evaluate the effects of fixed versus incremental pump speed on peak oxygen uptake (peak VO2) during a maximal exercise test. Methods and results In CF-LVAD (HeartMate II) patients exercise testing measuring peak oxygen uptake (VO2) was performed on an ergometer bike twice in one day: once with fixed pump speed (testfix) and once with incremental pump speed (testinc). The order of testfix and testinc in each patient was determined by randomization. During testinc pump speed was increased from the baseline value by 400 rpm/2 min. Fourteen patients (aged 23-69 years) were included with a mean support duration of 465 ± 483 days. Baseline CF-LVAD speed was 9357 ± 238 rpm and during testinc speed was increased by a mean of 1486 ± 775 rpm. Mean peak VO2 was significantly higher in testinc compared with testfix (15.4 ± 5.9 mL/kg/min vs. 14.1 ± 6.3 mL/kg/min; P = 0.012), corresponding to a 9.2% increase. All exercise tests (n = 28) were adequately performed with RER > 1. Conclusion Increasing pump speed during exercise augments peak VO2 in patients supported with CF-LVADs. An automatic speed-change function in future generations of CF-LVADs might improve functional capacity.

KW - Heart failure

KW - LVAD

KW - Peak oxygen uptake

KW - Ventricular assistance

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