Pilot study in patients with continuous flow left ventricular assist device (cfLVAD) to proof the feasibility of a specific individual training at home aimed to increase pulse pressure above a predefined threshold which might attenuate the loss of arterial wall thickness. Hypothesis: Increasing daily physical activity near to normal (\> 10.000 steps per day) with a pre-defined level of pulse pressure (intensity) is a realizable and feasible approach to investigate changes in arterial wall thickness and cardio-respiratory capacity in cfLVAD patients.
The investigators will study 3 cfLVAD patients with low pulse pressure during work package 1 using two different exercises, treadmill and bicycle. Walking and cycling present the most commonly used physical activities which are applicable to most individuals on a daily basis. The investigators aim to demonstrate that individual changes of pulse pressure during these types of exercise can be assessed in cfLVAD patients. In a feasibility study (work package 2) the investigator will enroll 6 cfLVAD patients to perform home-based physical activity programs including walking a defined number of steps per day with a predefined speed and cycling with a predefined power \[watt\] on a bicycle ergometer. The performance of the patients will be monitored over seven days using a wearable activity device.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
7
A combination of walking (\> 10.000 steps per day) and cycling on a stationary bicycle at home at an individual intensity. For the activity walking patients need to walk at a certain speed (e.g. 3 km/h) in order to be in the range of pulsatility as obtained from their pre-training treadmill test. For cycling a defined power in watt and duration will be given to each patient as defined from the pre-training cycling test.
Hannover Medical School
Hanover, Lower Saxony, Germany
Change from baseline in brachial artery smooth muscle thickness
Unit: mm
Time frame: At baseline and after 2 months
Change from baseline in peak oxygen consumption
Unit: ml/min/kg
Time frame: At baseline and after 2 months
Change from baseline in pulse pressure during rest and exercise
Unit: mm/Hg
Time frame: At baseline and after 2 months
Change from baseline in daily physical activity
Unit: Steps per day assessed with a wearable activity device
Time frame: At baseline, after week 3, week 6, and after 2 months
Change from baseline in quality of life questionnaire (SF-36)
Unit: points
Time frame: At baseline and after 2 months
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