The Influence of Sex Differences on Cardiopulmonary Exercise Metrics Following Heart Transplant

Katelyn E. Uithoven, Joshua R. Smith, Jose R. Medina-Inojosa, Ray W. Squires, Erik H. Van Iterson, Thomas P. Olson

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Previous work has shown sex-related differences in cardiopulmonary responses in patients with heart failure (HF); however, sex differences following heart transplant (HTx) have not been examined. Thus, we hypothesized women would demonstrate lower peak oxygen uptake (VO2peak) but similar ventilatory efficiency (VE/VCO2 slope) compared with men prior to HTx. Furthermore, we hypothesized that, following HTx, women would exhibit greater improvements in VO2peak and VE/VCO2 slope compared with men. Methods: HTx patients with cardiopulmonary exercise testing (CPET) between 2007 and 2016 were included. Pre-HTx CPET occurred within 24 months pre-HTx with post-HTx CPET within 12 months following HTx. VO2peak was measured via standard protocol. VE/VCO2 slope was calculated using rest-peak ventilation (VE) and carbon dioxide production (VCO2). Results: Eighty-eight patients (Men [M]: n = 63, age: 55 ± 12 years; Women [W]: n = 25, age: 47 ± 11 years) were assessed. Pre-HTx VO2peak (M: 13.9 ± 5.0 vs W: 11.6 ± 3.9 mL/kg/min, P = 0.17) and VE/VCO2 slope (M: 42 ± 12 vs W: 46 ± 18, P = 0.53) were not different between sexes. Overall, VO2peak (Pre: 13.3 ± 4.8 vs Post: 18.4 ± 4.8 mL/kg/min, P < 0.01) and VE/VCO2 slope (Pre: 43 ± 14 vs Post: 37 ± 6, P = 0.02) improved following HTx. Post-VO2peak (M: 19.0 ± 4.8 vs W: 16.8 ± 4.5 mL/kg/min, P = 0.24) and VE/VCO2 slope (M: 37 ± 6 vs W: 37 ± 7, P = 0.99) and delta VO2peak (M: 5.0 ± 4.8 vs W: 5.3 ± 4.9 mL/kg/min, P = 0.85) and VE/VCO2 slope (M: –5 ± 11 vs W: –9 ± 17, P = 0.29) were not different between sexes. Conclusions: These data demonstrate that cardiopulmonary improvements following HTx patients occur for both sexes. Importantly, women show similar significant functional improvements following HTx compared with men.

Original languageEnglish (US)
JournalCanadian Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2019

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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