Nazir A. Exercise as a modality to improve heart transplantation-related functional impairments: An article review. World J Transplant 2024; 14(3): 91637 [DOI: 10.5500/wjt.v14.i3.91637]
Corresponding Author of This Article
Arnengsih Nazir, MD, MM, Academic Fellow, Attending Doctor, Consultant Physician-Scientist, Lecturer, Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38 Bandung 40161, West Java, Indonesia. arnengsih@unpad.ac.id
Research Domain of This Article
Rehabilitation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 18, 2024; 14(3): 91637 Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.91637
Exercise as a modality to improve heart transplantation-related functional impairments: An article review
Arnengsih Nazir
Arnengsih Nazir, Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Bandung 40161, West Java, Indonesia
Author contributions: Nazir A contributed to all manuscript processes.
Conflict-of-interest statement: The author declares no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arnengsih Nazir, MD, MM, Academic Fellow, Attending Doctor, Consultant Physician-Scientist, Lecturer, Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38 Bandung 40161, West Java, Indonesia. arnengsih@unpad.ac.id
Received: January 1, 2024 Revised: June 14, 2024 Accepted: July 2, 2024 Published online: September 18, 2024 Processing time: 212 Days and 0.9 Hours
Abstract
Heart transplantation (HT), the treatment choice of advanced heart failure patients, is proven effective in increasing the survival and functional status of the recipients. However, compared to normal controls, functional status is lower in HT recipients. Exercise given in cardiac rehabilitation has been shown to improve exercise capacity as measured with peak oxygen uptake (VO2 peak) and muscle strength after completion of the program and cessation of exercise results in loss of exercise benefits. Several factors related to cardiac denervation and the use of immunosuppressive agents in HT recipients result in functional impairments including cardiovascular, pulmonary, exercise capacity, psychological, and quality of life (QoL) problems. High-intensity interval training (HIIT) is the most common type of exercise used in HT recipients and given as a hospital-based program. Improvement of functional impairments was found to have occurred due to primarily musculoskeletal adaptations through improvement of muscle structure and aerobic capacity and cardiovascular adaptations. In general, exercise given after transplantation improved VO2 peak significantly and improvement was better in the HIIT group compared to moderate intensity continuous training or no-exercise groups. Improvement of QoL was ascribed to improvement of exercise capacity, symptoms, pulmonary function, physical capacity improvement, anxiety, and depression.
Core Tip: Heart transplantation is proven effective in increasing the survival and functional status of the recipients, but compared to normal controls, their functional status is lower. Exercise is shown to improve exercise capacity and its cessation causes the loss of its benefits. Cardiac denervation and immunosuppressive agents used in heart transplantation recipients result in cardiovascular, pulmonary, exercise capacity, psychological, and quality of life problems. Functional improvement is mainly due to musculoskeletal and cardiovascular adaptations. The greatest improvement in exercise capacity was found in recipients given supervised high-intensity training. Quality of life improvement resulted from the improvement of exercise capacity and symptoms.
