Long-term cardiorespiratory results of exercise training following cardiac transplantation

The long-term influence of exercise training after heart transplantation remains unclear. Accordingly, we performed a 12-year follow-up study of 36 patients who underwent heart transplantation. Findings for survivors were compared with those of age-matched controls over the same period. Comparisons were also made between survivors and deceased patients. The sample comprised 36 men (aged 47 ± 9 years) and a group of healthy age-matched controls. The patients received 16 months of outpatient exercise training; physiologic data were collected initially and at discharge. At 12 years, further data were collected on 20 of 23 survivors and their controls; 3 of the survivors were unavailable for final assessment, and 13 patients had died in the interim. The survivors’ peak oxygen intake (V̇O2peak) increased 26% after training and decreased 0.39 mlkg−1min−1 per year (27.9 ± 7 to 23.7 ± 6), which was a similar rate as the controls (0.37 mlkg−1min−1 per year; 33.7 ± 7 to 29.2 ± 7). Lean body mass (LBM) increased 3 kg by 16 months and a further 2.5 kg by 12 years, but ultimately was 3 kg below the controls. Although there was no difference in entry data between deceased patients and survivors, the latter attained greater gains in V̇O2peak and LBM over the 16 months of training. Thus, in heart transplantation patients who undergo training, gains in exercise capacity are lost over 12 years at a rate commensurate with normal aging. A reduced training response in V̇O2peak and LBM contributes to a poorer prognosis.