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The role of exercise hemodynamics in assessing patients with chronic heart failure and left ventricular assist devices

Lookup NU author(s): Dr Aaron Koshy, Dr Tom Green, Dr Sophie Cassidy, Dr Stephan Schueler, Professor Djordje JakovljevicORCiD, Dr Guy MacGowanORCiD


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© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.Introduction: Chronic heart failure is characterized by reduced exercise capacity. Invasive exercise hemodynamics are not routinely performed unless patients undergo transplant or left ventricular assist devices (LVAD) assessment, though now with readily available noninvasive devices, exercise hemodynamics are easily obtained. Our contention is that this is a valuable opportunity to acquire a more accurate measure of cardiac status in heart failure. Exercise hemodynamic measures such as cardiac power output can be carried out cheaply and effectively. Recent studies have highlighted the added value of exercise hemodynamics in prognostication of heart failure, and their role in assessing myocardial recovery in LVADs. Areas covered: In this review, we explore the literature available on Medline until 2019 focusing on resting and exercise hemodynamics alongside the methods of assessment (invasive and noninvasive) in heart failure with reduced ejection fraction and patients with implanted LVADs. Expert opinion: Hemodynamics measured both at rest and exercise are expected to play a significant role in the work up of transplant and LVAD patients. Furthermore, there is the potential to utilize noninvasive assessment in a complimentary fashion to support patient selection and improve the monitoring of response to treatment across the full cohort of heart failure patients.

Publication metadata

Author(s): Koshy A, Green T, Toms A, Cassidy S, Schueler S, Jakovljevic D, MacGowan GA

Publication type: Review

Publication status: Published

Journal: Expert Review of Medical Devices

Year: 2019

Volume: 16

Issue: 10

Pages: 891-898

Online publication date: 04/10/2019

Acceptance date: 30/09/2019

ISSN (print): 1743-4440

ISSN (electronic): 1745-2422

Publisher: Taylor and Francis Ltd


DOI: 10.1080/17434440.2019.1675506

PubMed id: 31584302