Table 2. Comparison of the results of 11 studies evaluating exercise capacity at different pump speed settings in patients with a left ventricular assist device.
| Author | Adverse events | Effects of higher rpm on peak exercise | Other remarkable effects of higher rpm | ||
|---|---|---|---|---|---|
| Exercise time or work load | TCO | VO2 | |||
| Jakovljevic et al. (21) | None | ↑ 18% | ↑ 30% | ↑ 23% | At peak exercise: CPO ↑ 39% |
| Brassard et al. (22) | None | ↔ | ↔ | NA | At 60 W: TCO ↑ 7%; MCAV ↑ 10%; At peak exercise: MCAV ↑ 8% |
| Noor et al. (23) | NA | ↑ 10% | NA | ↔ | At AT: VO2 ↔; in general: VE/VCO2 ↓ 13%; also, the impact of reduced speed was higher in patients with LVEF <40% |
| Salamonsen et al. (24) | NA | ↑ 16% | NA | ↑ 9% | At AT: VO2 ↑ 23%; At peak exercise: LVAD flow ↑ 35%; in general: BNP ↓ 78% |
| Jung et al. (25) | None | ↔ | NA | ↑ 9% | At peak exercise: LVAD flow ↑ 24%; in general: VE/VCO2 ↓ 13% |
| Mezzani et al. (27) | None | NA | ↑ 7% | ↑ 7% | At peak exercise: LVAD flow ↑ 9%; in general: the impact of increasing speed was higher in patients with TAPSE >13 mm |
| Jung et al. (26) | NA | NA | NA | NA | At 25 W: TCO ↑ 17%, RVEDD ↑ 9%; in general: no impact of increasing speed in PCWP and LVEDD |
| Hayward et al. (28) | NA | ↔ | NA | ↔ | At peak exercise: LVAD flow ↑ 40%, NT-proBNP ↓ 21%; of note: impact of increasing speed on peak workload (P=0.08) and 6MWD (P=0.10) |
| Fresiello et al. (29) | Yes | ↔ | NA | ↔ | At peak exercise: LVAD flow ↑ 27% |
| Jung et al. (30) | None | NA | NA | NA | At 10 W below AT: exercise time ↑ 13%; in general: older patients tended to benefit from increased speed |
| Vignati et al. (31) | NA | NA | ↑ 11% | ↑ 8% | At AT: VO2 ↑ 11%; in general: VE/VCO2 ↓ 13% |
AT, anaerobic threshold; BNP, brain natriuretic peptide; CPO, cardiac power output; LVAD, left ventricular assist device; LVEDD, left ventricular end-diastolic diameter; MCAV, middle cerebral artery mean velocity; NA, not available; NT-proBNP, NT-pro-brain natriuretic peptide; rpm, revolutions per minute; PCWP, pulmonary capillary wedge pressure; RVEDD, right ventricular end-diastolic diameter; TAPSE, tricuspid annular plane systolic excursion; TCO, total cardiac output; VE/VCO2, relationship between minute ventilation and the rate of carbon dioxide reduction; VO2, oxygen uptake; 6MWD, six-minute walking distance.