Rehabilitation after cardiac transplantation
- Ileana L Piña, MD, MPH
Ileana L Piña, MD, MPH
- Professor of Medicine and Epidemiology/Population Health
- Albert Einstein College of Medicine
- Associate Chief of Cardiology for Academic Affairs
- Montefiore-Einstein Medical Center
In spite of dramatic advances in the survival of cardiac transplant recipients, published reports have consistently shown abnormal levels of functional capacity. Although there is a rapid rise in exercise capacity that occurs at approximately two months post-transplant , and many patients return to their normal activities with improved quality of life, exercise function remains 30 to 40 percent below normal [2,3]. Unfortunately in the United States, participation in cardiac rehabilitation is low and varies by region and yet could reduce readmissions. This observation in 2531 post-transplant patients associating participation in cardiac rehabilitation with a lower one-year readmission for Medicare beneficiaries adds a significant layer of benefit .
Prior studies describing persistently abnormal exercise capacity in the early post-transplant period suggested several possible explanations, including :
●Marked deconditioning prior to transplant due to heart failure (HF) or due to extended mechanical assistance with a left ventricular assist device. (See "Skeletal muscle dysfunction and exercise intolerance in heart failure" and "Intermediate- and long-term mechanical circulatory support" and "Practical management of long-term mechanical circulatory support devices".)
●Surgical denervation of the heart 
●Corticosteroid therapy-related myopathy (see "Glucocorticoid-induced myopathy")To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- EXERCISE CAPACITY AND REHABILITATION POST-TRANSPLANTATION
- - Exercise capacity
- - Effect of early rehabilitation
- - Exercise capacity
- - Effect of later rehabilitation
- TIMING OF CARDIAC REHABILITATION REFERRAL
- THE TRANSPLANT CARDIAC REHABILITATION PROGRAM
- Immediate post-transplantation rehabilitation
- Myopathy and resistance training
- Posthospital exercise prescription