Exercise after heart transplantation: An overview

Table 2 Possible mechanisms associated with reduced exercise capacity in heart transplant recipients

Central factors

Reduced cardiac output

Chronotropic incompetence

Reduced stroke volume

Systolic dysfunction

Diastolic dysfunction

Pulmonary dysfunction

Pulmonary hypertension

Lung disease

Pulmonary congestion

Peripheral factors

Decreased skeletal muscle function

Reduced muscle mass

Reduced muscle strength

Reduced capillary density

Reduced oxidative capacity

Reduced mitochondrial function

Corticosteroid induced myopathy

Impaired vasodilatory capacity

Endothelial dysfunction

Deconditioning

Potential factors contributing to reduced exercise capacity

Increasing age

Donor age

Donor match

Ischemic time

Pre transplant de-conditioning

Primary diagnosis

Co-morbidities

Smoking

Cultural differences

Gender differences

Anxiety and depression

Socio-economic status

Reduced health-related quality of life