Functional Endurance Capacity and Exercise Training in Long-Term Treatment after Heart Transplantation

OBJECTIVE: The aim of this study was to investigate the influence of cardiac denervation on endurance exercise capacity in heart transplant recipients (HTR) in comparison to patients with coronary artery disease (CAD). METHODS: We performed two successive incremental tests and a 30-min constant load test (CLT) in 20 HTR (55 +/- 7 years old, 4.9 +/- 2.2 years after transplantation) and in 13 patients with CAD (58 +/- 8 years). RESULTS: Maximal workload in HTR was 106 +/- 25 W (163 +/- 41 W; p < 0.01). In CLT at anaerobic threshold of 55 +/- 6 W (97 +/- 34 W; p < 0.01), lactate increased from 0.9 +/- 0.2 (1.0 +/- 0.2) to 2.9 +/- 1.3 (3.3 +/- 1.3) after 10 min and to 3.1 +/- 1.6 (3.4 +/- 1.5; NS) mmol. l(-1) after 30 min, confirming that the anaerobic threshold reflects a steady state. The CLT kinetics of heart rate (+6 beats in HTR and in CAD between 10th and 30th min) and lactate are comparable in HTR and CAD, demonstrating that endurance kinetics are not influenced by cardiac denervation.