• Cardiac rehabilitation
• Exercise tolerance
• Functional status
• Heart transplantation
• High-intensity interval training
• Muscle strength
• Quality of life

• Humans
• Cardiac Rehabilitation/methods
• Adult
• Middle Aged
• Patient Compliance/statistics & numerical data
• Adolescent
• Young Adult

• Diabetes
• Dyslipidaemia
• Exercise training
• Heart failure
• Heart transplantation
• Hypertension
• Physical activity
• Prevention
• Primary prevention
• Rehabilitation
• Risk factors
• Secondary prevention

• Heart Transplantation/adverse effects
• Heart Transplantation/rehabilitation
• Humans
• Consensus
• Heart Failure/rehabilitation
• Cardiac Rehabilitation
• Quality of Life
• Risk Factors
• Treatment Outcome
• Risk Reduction Behavior

• diabetes
• dyslipidaemia
• exercise training
• heart failure
• heart transplantation

• Humans
• Consensus
• Europe
• Exercise
• Heart Failure/rehabilitation
• Heart Failure/surgery
• Heart Transplantation/adverse effects
• Quality of Life
• Societies, Medical

• Heart transplant
• high intensity interval training
• meta-analysis
• rehabilitation
• systematic review

• AdHeart - Engage with your heart: Improving therapeutic adherence with a telemonitoring system for chronic heart failure patients
• European Regional Development Fund (ERDF), HEALTH-UNORTE

Studies on the effect of high-intensity interval training (HIT) compared with moderate intensity continuous training (MICT) on health-related quality of life (HRQoL) after heart transplantation (HTx) is scarce. No available studies among de novo HTx recipients exists. This study aimed to investigate the effect of HIT vs. MICT on HRQoL in de novo recipients.

The HITTS study randomized eighty-one de novo HTx recipients to receive either HIT or MICT (1:1). The HIT intervention were performed with 2–4 interval bouts with an intensity of 85–95% of maximal effort. The MICT group exercised at an intensity of 60–80% of their maximal effort with a duration of 25 min. HRQoL was assessed by the Short Form-36 version 2 (SF-36v2) and the Hospital Anxiety and Depression Scale, mean 11 weeks after surgery and after a nine months’ intervention. The participants recorded their subjective effect of the interventions on their general health and well-being on a numeric visual analogue scale. Clinical examinations and physical tests were performed. Differences between groups were investigated with independent Student t-tests and with Mann-Whitney U tests where appropriate. Within-group differences were analyzed with Paired-Sample t-tests and Wilcoxon Signed Rank tests. Correlations between SF-36 scores and VO_2peak were examined with Pearson’s correlations.

Seventy-eight participants completed the intervention. Both exercise modes were associated with improved exercise capacity on the physical function scores of HRQoL. Mental health scores remained unchanged. No differences in the change in HRQoL between the groups occurred except for Role Emotional subscale with a larger increase in the HIT arm. Better self-reported physical function was associated with higher VO_2peak and muscle strength.

HIT and MICT resulted in similar mean changes in HRQoL the first year after HTx. Both groups experienced significant improvements in the physical SF-36v2.

ClinicalTrials.gov number: NCT01796379 Registered 18 February 2013.

• Exercise
• Health-related quality of life
• Heart transplantation
• High-intensity interval training
• Moderate intensity continuous training
• Muscle strength,self-reported physical function
• Oxygen consumption

• Cardiac
• peripheral arterial disease
• rehabilitation
• revascularization

• Cardiopulmonary exercise testing
• exercise sessions
• major adverse cardiovascular events
• postoperative care

The measurement of peak oxygen uptake (VO_2peak) is an important metric for evaluating cardiac transplantation (HTx) eligibility. However, it is unclear which factors (e.g., recipient demographics, clinical parameters, cardiac rehabilitation (CR) participation) influence VO_2peak following HTx. Consecutive HTx patients with cardiopulmonary exercise testing (CPET) between 2007–2016 were included. VO_2peak was measured from CPET standard protocol. Regression analyses determined predictors of the highest post-HTx VO_2peak (i.e., quartile 4: VO_2peak > 20.1 mL/kg/min). One hundred-forty HTx patients (women: n = 41 (29%), age: 52 ± 12 years, body mass index (BMI): 27 ± 5 kg/m²) were included. History of diabetes (Odds Ratio (OR): 0.17, 95% Confidence Interval (CI): 0.04–0.77, p = 0.021), history of dyslipidemia (OR: 0.42, 95% CI: 0.19–0.93, p = 0.032), BMI (OR: 0.90, 95% CI: 0.82–0.99, p = 0.022), hemoglobin (OR: 1.29, 95% CI: 1.04–1.61, p = 0.020), white blood cell count (OR: 0.81, 95% CI: 0.66–0.98, p = 0.033), CR exercise sessions (OR: 1.10, 95% CI: 1.04–1.15, p < 0.001), and pre-HTx VO_2peak (OR: 1.17, 95% CI: 1.07–1.29, p = 0.001) were significant predictors. Multivariate analysis showed CR exercise sessions (OR: 1.10, 95% CI: 1.03–1.16, p = 0.002), and pre-HTx VO_2peak (OR: 1.16, 95% CI: 1.04–1.30, p = 0.007) were independently predictive of higher post-HTx VO_2peak. Pre-HTx VO_2peak and CR exercise sessions are predictive of a greater VO_2peak following HTx. These data highlight the importance of CR exercise session attendance and pre-HTx fitness in predicting VO_2peak post-HTx.

• cardiac rehabilitation
• cardiopulmonary exercise testing
• exercise capacity
• peak oxygen uptake
• postoperative care

• 18POST33990251 American Heart Association-American Stroke Association
• L30 HL138814 NHLBI NIH HHS

• cardiac rehabilitation
• cardiorespiratory fitness
• exercise
• exercise test
• metabolic equivalent

• Body Mass Index
• Cardiac Rehabilitation/methods
• Cardiorespiratory Fitness/physiology
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/physiopathology
• Cardiovascular Diseases/therapy
• Exercise Test
• Exercise Therapy/methods
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Morbidity/trends
• Ohio/epidemiology
• Retrospective Studies
• Survival Rate/trends
• Treatment Outcome

To study exercise capacity and determinants of early peak oxygen consumption (VO_2peak) in a cohort of de novo heart transplant (HTx) recipients.

To determine possible central (chronotropic responses, cardiopulmonary and hemodynamic function) and peripheral factors (muscular exercise capacity and body composition) predictive of VO_2peak, a number of different measurements and tests were performed, as follows: Cardiopulmonary exercise testing (CPET) was performed mean 11 wk after surgery in 81 HTx recipients > 18 years and was measured with breath by breath gas exchange on a treadmill or bicycle ergometer. Metabolic/respiratory measures include VO_2peak and VE/VCO₂ slope. Additional measures included muscle strength testing, bioelectrical impedance analysis, echocardiography, blood sampling and health-related quality of life. Based on the VO_2peak (mL/kg per minute) median value, the study population was divided into two groups defined as a low-capacity group and a high-capacity group. Potential predictors were analyzed using multiple regression analysis with VO_2peak (L/min) as the dependent variable.

The mean ± standard deviation (SD) age of the total study population was 49 ± 13 years, and 73% were men. This de novo HTx cohort demonstrated a median VO_2peak level of 19.4 mL/kg per min at 11 ± 1.8 wk post-HTx. As compared with the high-capacity group, the low-capacity group exercised for a shorter time, had lower maximal ventilation, O₂ pulse, peak heart rate and heart rate reserve, while the VE/VCO₂ slope was higher. The low-capacity group had less muscle strength and muscular exercise capacity in comparison with the high-capacity group. In order of importance, O₂ pulse, heart rate reserve, muscular exercise capacity, body mass index, gender and age accounted for 84% of the variance in VO_2peak (L/min). There were no minor or major serious adverse events during the CPET.

Although there is great individual variance among de novo HTx recipients, early VO_2peak measures appear to be influenced by both central and peripheral factors.

• Cardiopulmonary exercise testing
• Early VO_2peak
• De novo heart transplant
• Health related quality of life
• Muscle strength

• cardiac rehabilitation
• cardiac transplantation
• health services research
• heart transplantation
• readmissions
• rehabilitation

• Adult
• Aged
• Cardiac Rehabilitation
• Cohort Studies
• Female
• Heart Transplantation/adverse effects
• Heart Transplantation/rehabilitation
• Humans
• Male
• Medicare
• Middle Aged
• Odds Ratio
• Patient Acceptance of Health Care
• Patient Readmission
• Time Factors
• United States

• K12 HS022990 AHRQ HHS
• L30 HL134051 NHLBI NIH HHS
• UL1 TR000445 NCATS NIH HHS

• cardiac rehabilitation
• cardiopulmonary exercise testing
• coronary artery bypass grafting
• exercise training

• Adult
• Early Medical Intervention/methods
• Exercise Test/methods
• Female
• Heart Failure/diagnosis
• Heart Failure/metabolism
• Heart Failure/mortality
• Heart Failure/physiopathology
• Heart Failure/surgery
• Heart Transplantation/adverse effects
• Heart Transplantation/methods
• Heart Transplantation/mortality
• Heart Transplantation/rehabilitation
• Humans
• Long Term Adverse Effects/prevention & control
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Oxygen Consumption
• Perioperative Period/methods
• Perioperative Period/statistics & numerical data
• Proportional Hazards Models
• Retrospective Studies
• United States/epidemiology

• Cardiopatía isquémica
• Cirugía de revascularización miocárdica
• Coronary artery bypass surgery
• Ischemic heart disease
• Rehabilitación
• Rehabilitation
• Uruguay

• endurance exercise
• mitochondrial gene shifting
• mitochondrial myopathy
• resistance exercise
• satellite cells

While life expectancy is greatly improved after a heart transplant, survival is still limited, and compared to the general population, the exercise capacity and health-related quality of life of heart transplant recipients are reduced. Increased exercise capacity is associated with a better prognosis. However, although several studies have documented positive effects of exercise after heart transplantation (HTx), little is known about the type, frequency and intensity of exercise that provides the greatest health benefits. Moreover, the long-term effects of exercise on co-morbidities and survival are also unclear. Exercise restrictions apply to patients with a denervated heart, and for decades, it was believed that the transplanted heart remained denervated. This has since been largely disproved, but despite the new knowledge, the exercise restrictions have largely remained, and up-to-date guidelines on exercise prescription after HTx do not exist. High-intensity, interval based aerobic exercise has repeatedly been documented to have superior positive effects and health benefits compared to moderate exercise. This applies to both healthy subjects as well as in several patient groups, such as patients with metabolic syndrome, coronary artery disease or heart failure. However, whether the effects of this type of exercise are also applicable to heart transplant populations has not yet been fully established. The purpose of this article is to give an overview of the current knowledge about the exercise capacity and effect of exercise among heart transplant recipients and to discuss future exercise strategies.

• Heart transplant
• Exercise
• Exercise capacity
• Muscle strength
• Maximum oxygen uptake
• Denervation
• Reinnervation
• Cardiac allograft vasculopathy
• Quality of life

• Cardiac rehabilitation
• Health related quality of life
• Prospective pilot study
• Qualité de vie liée à l’état de santé
• Rééducation cardiaque
• Étude pilote prospective

• Adolescent
• Adult
• Child
• Exercise
• Exercise Therapy/methods
• Heart Failure/rehabilitation
• Heart Failure/therapy
• Heart Rate
• Heart Transplantation/methods
• Humans
• Postoperative Period
• Rehabilitation/methods

• Aerobic training
• cardiac rehabilitation
• energy expenditure
• peak VO2
• ventilatory thresholds