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Exercise gas exchange in continuous-flow left ventricular assist device recipients

Author

Listed:
  • Alessandro Mezzani
  • Massimo Pistono
  • Piergiuseppe Agostoni
  • Andrea Giordano
  • Marco Gnemmi
  • Alessandro Imparato
  • Pierluigi Temporelli
  • Ugo Corrà

Abstract

Exercise ventilation/perfusion matching in continuous-flow left ventricular assist device recipients (LVAD) has not been studied systematically. Twenty-five LVAD and two groups of 15 reduced ejection fraction chronic heart failure (HFrEF) patients with peak VO2 matched to that of LVAD (HFrEF-matched) and ≥14 ml/kg/min (HFrEF≥14), respectively, underwent cardiopulmonary exercise testing with arterial blood gas analysis, echocardiogram and venous blood sampling for renal function evaluation. Arterial-end-tidal PCO2 difference (P(a-ET)CO2) and physiological dead space-tidal volume ratio (VD/VT) were used as descriptors of alveolar and total wasted ventilation, respectively. Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio (TAPSE/PASP) and blood urea nitrogen/creatinine ratio were calculated in all patients and used as surrogates of right ventriculo-arterial coupling and circulating effective volume, respectively. LVAD and HFrEF-matched showed no rest-to-peak change of P(a-ET)CO2 (4.5±2.4 vs. 4.3±2.2 mm Hg and 4.1±1.4 vs. 3.8±2.5 mm Hg, respectively, both p >0.40), whereas a decrease was observed in HFrEF≥14 (6.5±3.6 vs. 2.8±2.0 mm Hg, p

Suggested Citation

  • Alessandro Mezzani & Massimo Pistono & Piergiuseppe Agostoni & Andrea Giordano & Marco Gnemmi & Alessandro Imparato & Pierluigi Temporelli & Ugo Corrà, 2018. "Exercise gas exchange in continuous-flow left ventricular assist device recipients," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0187112
    DOI: 10.1371/journal.pone.0187112
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