Benefits of exercise after a heart transplant

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Benefits of exercise after a heart transplant

Heart transplant recipients can initially expect to have benefits from exercise similar to those that other people with heart conditions may enjoy. A significant increase in overall cardiovascular fitness will occur in the first 2 to 6 months of training. The benefits of exercise for the transplant recipient include:

• Improved exercise endurance.
• Increased overall exercise intensity.
• Increased maximal heart rate.
• Improved blood pressure responses.
• Less fatigue and shortness of breath.
• Increased lean body mass, reduced body fat.
• Improved bone mineral density.

How your new heart responds to exercise

During your transplant surgery, some of the nerves that help control the function of your heart are cut, which results in your heart being slower to respond to exercise. In a normal heart, an increase of cardiac output (the total amount of blood that leaves the heart) is a result of an increase in heart rate as well as stroke volume (amount of blood leaving the heart per beat). In a transplanted heart, however, this increase in heart rate is delayed, and instead your stroke volume provides the amount of blood that your body needs. Your heart rate will increase if you exercise hard, but only after your stroke volume can no longer provide enough blood to your body.

This is important to know, because it means that your heart rate will not increase when you exercise the way it used to with your old heart. Also, your new heart will have a higher heart rate when you are resting (about 95 to 115 beats per minute [bpm]), as well as a lower maximum heart rate when you are exercising (about 150 bpm). Therefore, measuring your heart rate is not a good way to measure how hard you are exercising. Instead, you may need to monitor other signs such as blood pressure, rate of perceived exertion (RPE), and shortness of breath while you are exercising.

Your heart rate may be highest right after you finish exercising and will remain high. You will also need to give your new heart longer to cool down afterward.

Due to this delayed heart rate response to exercise and the smaller-than-normal stroke volume, your overall exercise cardiac output may be lower than that of the average person. This means that you may achieve a lower overall cardiovascular fitness level than if you had an original healthy heart.

If your heart shows signs of rejection

Occasionally, your immune system may attack your new heart. This is known as a rejection episode. Fortunately, your physician can usually stop a rejection episode by giving you medications. The severity of the episode will be classified as mild, moderate, or severe. Your scheduled exercise program may need to be modified if you have a moderate or severe rejection episode. Your doctor may tell you to continue your regular exercise program but not to progress until your rejection factors decrease. Severe rejection may require you to stop your regular exercise program.

Credits

Last updated:	October 08, 2008
Author:	Robin Parks, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC