Cardiac and Cerebrovascular Response to Exercise in the Setting of Mechanical Circulatory Support among Individuals with Advanced Heart Failure

Purpose To characterize cardiovascular and cerebrovascular responses to exercise among individuals with continuous-flow left ventricular assist devices (CF-LVAD). Methods 9 CF-LVAD subjects, 11 patients with advanced heart failure with reduced ejection fraction (HFrEF, all New York Heart Association IIIB-IV with left ventricular ejection fraction Results Demographics are reported in Table 1. As demonstrated in Figure 1, workload and VO2 were similar between HFrEF and CF-LVAD groups, and significantly less than levels observed among HCs. Similarly, the increase in MAP and Qc throughout exercise was blunted among HFrEF and CF-LVAD groups in comparison to HCs. MCAV increased throughout exercise among HCs, but was relatively unchanged among HFrEF and CF-LVAD groups. Conclusion Despite restoration of resting Qc, CF-LVAD implantation is associated with a blunted cardiovascular and cerebrovascular response to exercise compared to healthy individuals, with exertional hemodynamics that are similar to individuals with advanced HFrEF.