Impact of Heart Transplantation on the Recovery of Peripheral and Respiratory Muscle Mass and Strength in Patients With Chronic Heart Failure

Transplant Direct. 2018 Oct 1;4(11):e395. doi: 10.1097/TXD.0000000000000837. eCollection 2018 Nov.

Abstract

Background: To assess the impact of heart transplantation (HT) on the recovery of peripheral and respiratory muscle mass and strength in patients with congestive heart failure.

Methods: The study included 23 patients with an indication for HT (patients in the waiting list [WL] group). These patients were monitored for 1.5 to 3 years after HT; 8 died before 6 months of follow-up, 15 patients completed the early follow-up period of 6 months after HT (FU6m group), 4 died between 6 months and 3 years after HT, and 11 patients completed the late follow-up period 1.5 to 3 years after HT (FU1.5-3y group). Twenty-three healthy subjects were included in the control group. The study variables included inspiratory muscle strength, expressed as the maximum inspiratory pressure (MIP); expiratory muscle strength, expressed as the maximum expiratory pressure (MEP); peripheral muscle strength, expressed as bilateral handgrip strength (bHGS); and the cross-sectional area of the bilateral psoas major muscle (CSAbPm).

Results: The results showed a reduction in the CSAbPm (1238.9 ± 312.3 mm2), a reduction in the bHGS (27.0 ± 5.7 kg/f), a reduction in the MIP (60.2 ± 29.8 cmH2O), and a reduction in the MEP (75.2 ± 33.4 cmH2O) in patients in the WL group compared with the healthy controls. In the time series comparison, for patients in the WL, FU6m, and FU1.5-3y groups, increases were found in the CSAbPm (1305.4 vs 1458.1 vs 1431.3 mm2, respectively), bHGS (27.3 vs 30.2 vs 34.7 kg/f, respectively), MIP (59.5 vs 85.5 vs 90.9 cmH2O, respectively), and MEP (79.5 vs 93.2 vs 101.8 cmH2O, respectively) (P < 0.00).

Conclusions: Sarcopenia was observed in patients in the WL group. Patients recovered peripheral and respiratory muscle mass and strength at 3 years after HT.