The text covers the physiology of myocardial dysfunction, the transplanted heart, and ventricular assist devices as they affect exercise capacity and responses during exercise and exertion. It goes on to discuss in more depth the exercise testing of patients, including the methods and utility of ventilatory gas analysis, the physiologic and clinical effects of exercise training on these patients, and ecommended exercise training programs
This text, part of the American Heart Association Monograph Series, provides a cogent and comprehensive overview of its topic that should be of practical value to a broad range of physicians, exercise physiologists and consultants working in this field.
Section 1: Epidemiology of Left Ventricular Dysfunction.
1. Epidemiology of Heart Failure: Evolving Trends.
N.B. Shah, B.M. Massie.
2. Economics of Heart Failure.
M.A. Konstam, C.D. Kimmelstiel.
Section 2: Heart Failure and Exercise Tolerance.
3. Systolic Failure.
4. Exercise, Diastolic Function and Dysfunction.
C.S. Apstein, J.R. Libonati, N. Varma, F.R. Eberli.
5. Neurohormonal Responses to Exercise in Heart Failure.
6. The Transplanted Heart.
Section 3: Therapeutic Approaches to Heart Failure and Their Impact on Exercise Tolerance.
7. Overview of Medical Therapy in Heart Failure: The Challenge of Rational Polypharmacy.
8. Effects of Long-Term Beta-Adrenergic Blockade on Exercise Capacity in Patients with Chronic Heart Failure.
E.E. Wolfel, M.R. Bristow.
9. Cardiac Transplantation: Current Concepts and Future Directions.
M. Argenziasno, E.A. Rose.
10. Cardiac Transplantation: Trends, Techniques and Bridges.
11. Long-Term Implant of Left Ventricular Assist Devices.
B.E. Jaski, R.S. Maly.
Section 4: Exercise Testing and Expired Gas Analysis.
12. Exercise Testing Protocols for Use in Heart Failure.
13. Ventilatory Gas Exchange in Heart Failure: Techniques, Problems, and Pitfalls.
14. Clinical Utility of Cardiopulmonary Exercise Testing Data in Heart Failure.
Section 5: Physiological Responses to Exercise Training.
15. Cardiovascular Adaptations to Exercise Training in Left Ventricular Dysfunction.
M.J. Sullivan, B.D. Duscha.
16. Skeletal Muscle and the Role of Exercise Training in Chronic Heart Failure.
J.R. Wilson, D.B. Chomsky.
17. Central and Peripheral Responses to Training after Cardiac Transplantation.
Section 6: The Exercise Training Program.
18. Screening and Evaluation of Patients for Exercise Training.
G.F. Fletcher, V. Fernandez.
19. Training Methods and Monitoring of the Heart Failure Patients.
B.J. Fletcher, S. Dunbar.
20. Training Methods and Monitoring of Cardiac Transplant Patients.
21. Costs and Reimbursement Issues for Exercise Training Programs.
Ileana Pina Director, Section of Heart Failure and Cardiac Transplantation, Case Western Reserve University, Cleveland, OH.