Effects of exercise-based cardiac rehabilitation on exercise capacity in elderly heart transplant recipients: A systematic review

Abstract

Heart transplantation (HTx) not only reduces mortality of patients with end-stage heart failure (HF), but also improves the quality of life of these patients. However, heart transplant recipients (HTRs) experience a decrease in exercise capacity, which is associated with increased mortality of cardiovascular patients. This literature review provides not only the basic clinical application of HTx, such as recipient selection and surgical techniques, but also unique physiological abnormalities after surgery. Factors that are related to chronotropic incompetence, side effects of immunosuppressant medications, and deconditioning result in decreased exercise performance in HTRs. The benefits of exercise-based cardiac rehabilitation (CR) are outlined in this literature review. Exercise training (ET), which consists of aerobic, resistance and flexibility exercises, is effective in improving peak oxygen consumption (VO2peak) and skeletal muscle performance in HTRs. There is evidence that the use of high-intensity interval training (HIIT) can improve chronotropic responses to exercise and reduce the progression of cardiac allograft vasculopathy (CAV), which limits long-term survival rates in HTRs. Finally, it should be noted that the normal ageing process may affect long-term outcomes of ET in HTRs.