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Impact of right ventricular reserve on exercise capacity and quality of life in patients with left ventricular assist device

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Title: Impact of right ventricular reserve on exercise capacity and quality of life in patients with left ventricular assist device
Authors: Takenaka, Sakae Browse this author
Sato, Takuma Browse this author
Nagai, Toshiyuki Browse this author →KAKEN DB
Omote, Kazunori Browse this author
Kobayashi, Yuta Browse this author
Kamiya, Kiwamu Browse this author
Konishi, Takao Browse this author
Tada, Atsushi Browse this author
Mizuguchi, Yoshifumi Browse this author
Takahashi, Yuki Browse this author
Naito, Seiichiro Browse this author
Saiin, Kohei Browse this author
Ishizaka, Suguru Browse this author
Wakasa, Satoru Browse this author →KAKEN DB
Anzai, Toshihisa Browse this author →KAKEN DB
Keywords: exercise capacity
health-related quality of life
left ventricular assist device
right ventricular reserve
Issue Date: Mar-2023
Publisher: American Physiological Society
Journal Title: American journal of physiology. Heart and circulatory physiology
Volume: 324
Issue: 3
Start Page: H355
End Page: H363
Publisher DOI: 10.1152/ajpheart.00626.2022
Abstract: Although measuring right ventricular (RV) function during exercise is more informative than assessing it at rest, the relationship between RV reserve function, exercise capacity, and health-related quality of life (HRQoL) in patients with left ventricular assist devices (LVAD) remains unresolved. We aimed to investigate whether RV reserve assessed by the change in RV stroke work index (RVSWI) during exercise is correlated with exercise capacity and HRQoL in patients with LVAD. We prospectively assessed 24 consecutive patients with LVAD who underwent invasive right heart catheterization in the supine position. Exercise capacity and HRQoL were assessed using the 6-min walk distance (6 MWD) and peak oxygen consumption (V_ O2) in cardiopulmonary exercise testing, and the EuroQol visual analog scale (EQ-VAS), respectively. The patients were divided into two groups according to the median ARVSWI (change from rest to peak exercise). Patients with lower ARVSWI had significantly lower changes in cardiac index and absolute value of RV dP/dt than those with higher ARVSWI. The ARVSWI was positively correlated with 6 MWD (r = 0.59, P = 0.003) and peak V_ O2 (r = 0.56, P = 0.006). In addition, ARVSWI was positively correlated with the EQ-VAS (r = 0.44, P = 0.030). In contrast, there was no significant correlation between RVSWI at rest and 6 MWD (r = -0.34, P = 0.88), peak V_ O2 (r = 0.074, P = 0.74), or EQ-VAS (r = 0.127, P = 0.56). Our findings suggest that the assessment of RV reserve function is useful for risk stratification in patients with LVAD. NEW & NOTEWORTHY The change in right ventricular stroke work index (RVSWI) during exercise, not RVSWI at rest, was associated with exercise capacity and HRQoL. Our findings suggest that the assessment of change in RVSWI during exercise as a surrogate of RV reserve function may aid in risk stratification of patients with LVAD.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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