Exercise capacity following heart transplant: case report on the physical work capacity of a 37 year old competitive cyclist following orthotopic heart transplant

A project presented to the Department of Physician Assistant of Wichita State University in partial fulfillment of the requirements for the degree of Master of Physician Assistant.Physical work capacity (PWC) in heart transplant recipients (HTR) typically does not exceed 60% of age-predicted normal levels. It is unknown what levels might be achieved in these patients if they were involved in strenuous exercise training prior to transplantation. A 37 year-old, professionally trained male cyclist suffered an acute myocardial infarction (AMI) immediately following a road race and received a heart transplant four months later. The participant resumed training for competitive cycling one month following the transplant. Training was tolerated without any problems. A peak VO2 of 33.8 ml•kg-1•min-1 was achieved at a peak working rate of 250 Watts during a bicycle ergonometry maximal exercise test. Peak heart rate (HR) was 165 bpm. Peak VO2 was 92% and peak HR was 90% of age predicted values. These results were similar to heart transplant recipients (HTR) who trained for 36+24 months following their transplant14. Results indicate that for this participant, a more aggressive approach to heart transplant recovery was well tolerated and suggests that similar programs could be applied to heart transplant recipients with similar motivation and activity histories