Effect of mechanIcal circulatoRy Support ON Exercise Capacity aMong pAtieNts With Heart Failure
Effect of mechanIcal circulatoRy Support ON Exercise Capacity aMong pAtieNts With Heart Failure
This study will evaluate how the cardiovascular system interacts with mechanical hearts to
 provide blood flow to the body during exercise. Two aims are proposed: 1) to determine the
 impact of a mechanical heart on exercise pressor reflexes in heart failure patients; and 2)
 to define the primary determinant(s) of exercise capacity in heart failure patients before
 and after device implantation.
Advanced Heart Failure-

 Inclusion Criteria:

 -  Individuals with severely reduced left ventricular systolic function that are
 scheduled to undergo LVAD insertion

 Exclusion Criteria:

 -  uncontrolled diabetes with peripheral neuropathy (interferes with acquisition of MSNA
 signal)

 -  Individuals with clinical right ventricular failure, defined as moderate-severely
 reduced RV systolic function on echocardiography, or clinical evidence of RV failure
 (elevated jugular venous pressures, significant peripheral edema)

 -  Individuals with moderate-severe preexisting aortic insufficiency, as these patients
 will typically undergo a Park stitch at time of CF-LVAD insertion to permanently close
 the aortic valve and prevent worsening aortic insufficiency; and

 -  Disorders that adversely influence exercise ability (e.g. arthritis, peripheral
 vascular disease, pulmonary disease)

 Mild Heart Failure -

 Inclusion Criteria:

 -  Individuals with medically managed left ventricular systolic function that are NOT
 scheduled to undergo LVAD insertion

 -  HF patients with ejection fraction <35-40%

 Exclusion Criteria:

 -  Individuals requiring systemic anticoagulation with vitamin-K antagonists or
 new/direct oral anticoagulants ("NOAC"/"DOAC")

 -  Disorders that adversely influence exercise ability (e.g. arthritis, peripheral
 vascular disease, pulmonary disease)

 -  History of uncontrolled arrhythmias (e.g. ventricular tachycardia or nonsustained
 ventricular tachycardia).

 Healthy Controls -

 Inclusion Criteria:

 - Persons without a past medical history of cardiovascular disease or related disease (e.g.
 hypertension, diabetes, peripheral vascular disease, arrhythmias, stroke/transient ischemic
 attack) and are not taking any cardiac-related medications (e.g. antihypertensive
 medications)

 Exclusion Criteria:

 -  Individuals requiring systemic anticoagulation with vitamin-K antagonists or
 new/direct oral anticoagulants ("NOAC"/"DOAC")

 -  Disorders that adversely influence exercise ability (e.g. arthritis, peripheral
 ascular disease).