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Performance Limitations in Heart Transplant Recipients

Tucker, Wesley J.1,2; Beaudry, Rhys I.1; Samuel, T. Jake2; Nelson, Michael D.2; Halle, Martin3; Baggish, Aaron L.4; Haykowsky, Mark J.1

Exercise and Sport Sciences Reviews: July 2018 - Volume 46 - Issue 3 - p 144–151
doi: 10.1249/JES.0000000000000149
Perspective for Progress

We hypothesize that the reduced peak aerobic power (peak V˙O2) after heart transplantation is due to impaired cardiovascular and skeletal muscle function, and its improvement with short-term (≤1 yr) exercise training is primarily due to favorable skeletal muscle adaptations. Furthermore, the increased peak V˙O2 with long-term (>2 yr) training is primarily mediated by cardiac (sympathetic) reinnervation.

Heart transplant recipients have reduced peak V˙O2 through central and peripheral limitations. Exercise training increases peak V˙O2 via peripheral adaptations.

1College of Nursing and Health Innovation and

2Department of Kinesiology, University of Texas at Arlington, Arlington, TX;

3Department of Prevention, Rehabilitation, and Sports Medicine, Technical University Munich, Munich, Germany; and

4Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA

Address for correspondence: Mark J. Haykowsky, Ph.D., College of Nursing and Health Innovation, University of Texas at Arlington, 411 S Nedderman Dr, Arlington, TX 76010 (E-mail:

Accepted for publication: December 20, 2017.

Editor: Hirofumi Tanaka, Ph.D., FACSM.

© 2018 American College of Sports Medicine