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Physical Activity Guided by Pulse Pressure in Patients with Continuous Flow Left Ventricular Assist Devices: A Pilot Study.

Physical Activity Guided by Pulse Pressure in Patients with Continuous Flow Left Ventricular Assist Devices: A Pilot Study.
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Haufe S, Bara C, Eigendorf J, Chobanyan-Jürgens K, Rojas SV, Schmitto JD, Tegtbur U, Jordan J, Tank J,


Haufe S, Bara C, Eigendorf J, Chobanyan-Jürgens K, Rojas SV, Schmitto JD, Tegtbur U, Jordan J, Tank J, (click to view)

Haufe S, Bara C, Eigendorf J, Chobanyan-Jürgens K, Rojas SV, Schmitto JD, Tegtbur U, Jordan J, Tank J,

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Circulation 2017 03 10() pii CIRCULATIONAHA.116.026000
Abstract

Continuous flow left ventricular assist devices (cfLVADs) are increasingly used as bridge to cardiac transplantation or destination therapy in patients with end-stage heart failure.(1) Patients implanted with cfLVADs exhibit marked arterial pulse pressure (PP) reductions which could adversely affect cardiovascular health. Indeed, a pulsatile blood pressure provides stimuli for vascular smooth muscle cell growth and arterial baroreceptor functions.(2, 3) LVAD designs attempting to simulate PP have been developed recently with the hope to improve clinical outcomes.(4) Perhaps, physiological PP could be augmented through regular physical exercise in non-pulsatile patients implanted with cfLVADs. Yet, specific recommendations guiding exercise intervention following cfLVAD implantation do not exist. We reasoned that a standardized exercise training regimen could be developed based upon a reference of exercise-induced pulse pressure. In this pilot study, we tested the hypothesis that the in-laboratory evaluation of PP during exercise by photoplethysmography could serve as a guide for home-based walking and cycling exercise prescriptions.

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