. 2024 Sep;26(9):1876-1892.

doi: 10.1002/ejhf.3185. Epub 2024 Jun 19.

Prevention and rehabilitation after heart transplantation: A clinical consensus statement of the European Association of Preventive Cardiology, Heart Failure Association of the ESC, and the European Cardio Thoracic Transplant Association, a section of ESOT

Maria Simonenko¹, Dominique Hansen^{2

3}, Josef Niebauer⁴, Maurizio Volterrani⁵, Stamatis Adamopoulos⁶, Cristiano Amarelli⁷, Marco Ambrosetti⁸, Stefan D Anker⁹, Antonio Bayes-Genis¹⁰, Tuvia Ben Gal¹¹, T Scott Bowen¹², Francesco Cacciatore¹³, Giuseppe Caminiti⁵, Elena Cavarretta^{14

15}, Ovidiu Chioncel^{16

17}, Andrew J S Coats¹⁸, Alain Cohen-Solal¹⁹, Flavio D'Ascenzi²⁰, Carmen de Pablo Zarzosa²¹, Andreas B Gevaert^{22

23}, Finn Gustafsson²⁴, Hareld Kemps^{25

26}, Loreena Hill²⁷, Tiny Jaarsma^{28

29}, Ewa Jankowska³⁰, Emer Joyce^{31

32}, Nicolle Krankel³³, Mitja Lainscak³⁴, Lars H Lund³⁵, Brenda Moura^{36

37}, Kari Nytrøen³⁸, Elena Osto^{39

40}, Massimo Piepoli^{41

42}, Luciano Potena⁴³, Amina Rakisheva^{44

45}, Giuseppe Rosano⁴⁶, Gianluigi Savarese⁴⁷, Petar M Seferovic⁴⁸, David R Thompson²⁷, Thomas Thum⁴⁹, Emeline M Van Craenenbroeck^{22

23}

Affiliations

¹ Cardiopulmonary Exercise Test Research Department, Heart Transplantation Outpatient Department, V.A. Almazov National Medical Research Centre, St. Petersburg, Russia.
² REVAL and BIOMED Rehabilitation Research Center, Hasselt University, Hasselt, Belgium.
³ Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.
⁴ University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.
⁵ Cardio-Pulmonary Department, IRCCS San Raffaele Roma, Rome, Italy.
⁶ Heart Failure and Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens, Greece.
⁷ Department of Cardiac Surgery and Transplants, Monaldi Hospital, Azienda dei Colli, Naples, Italy.
⁸ Cardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital, Rivolta d'Adda (CR), Italy.
⁹ Department of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁰ University Hospital Germans Trias and Pujol de Badalona, Badalona, Spain.
¹¹ Heart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹² School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK.
¹³ Department of Translational Medicine, University of Naples 'Federico II', Naples, Italy.
¹⁴ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
¹⁵ Mediterranea Cardiocentro, Naples, Italy.
¹⁶ Emergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu', Bucharest, Romania.
¹⁷ University of Medicine Carol Davila, Bucharest, Romania.
¹⁸ Heart Research Institute, Sydney, NSW, Australia.
¹⁹ Cardiology Department, University of Paris, INSERM UMRS-942, Hopital Lariboisiere, AP-HP, Paris, France.
²⁰ Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
²¹ Department of Cardiology, Ramón y Cajal University Hospital, Madrid, Spain.
²² Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium.
²³ Department of Cardiology, Antwerp University Hospital, Edegem, Belgium.
²⁴ Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
²⁵ Department of Cardiology, Maxima Medical Centre, Eindhoven, The Netherlands.
²⁶ Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands.
²⁷ School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
²⁸ Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden.
²⁹ Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands.
³⁰ Wroclaw Medical University, Wroclaw, Poland.
³¹ Department of Cardiology, Mater University Hospital, Dublin, Ireland.
³² School of Medicine, University College Dublin, Dublin, Ireland.
³³ Universitätsmedizin Berlin Campus Benjamin Franklin Klinik für Kardiologie Charite, Berlin, Germany.
³⁴ General Hospital Murska Sobota, Murska Sobota, Slovenia.
³⁵ Department of Medicine, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
³⁶ Armed Forces Hospital, Porto, Portugal.
³⁷ Centre for Health Technologies and Services Research, Faculty of Medicine of University of Porto, Porto, Portugal.
³⁸ Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
³⁹ Division of Physiology and Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria.
⁴⁰ Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
⁴¹ Dipartimento Scienze Biomediche per la Salute, Universita' Degli Studi di Milan, Milan, Italy.
⁴² Cardiologia Universitaria, IRCCS Policlinico San Donato, Milan, Italy.
⁴³ University Hospital of Bologna, Bologna, Italy.
⁴⁴ Department of Cardiology, Scientific Institution of Cardiology and Internal Diseases, Almaty, Kazakhstan.
⁴⁵ Department of Cardiology, Kapshagai City Hospital, Almaty, Kazakhstan.
⁴⁶ St. George's Hospital NHS Trust University of London, London, UK.
⁴⁷ Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
⁴⁸ Faculty of Medicine and Heart Failure Center, University of Belgrade, Belgrade University Medical Center, Belgrade, Serbia.
⁴⁹ Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School and Fraunhofer Institute for Toxicology and Experimental Research, Hannover, Germany.

PMID: 38894693
DOI: 10.1002/ejhf.3185

Free article

Prevention and rehabilitation after heart transplantation: A clinical consensus statement of the European Association of Preventive Cardiology, Heart Failure Association of the ESC, and the European Cardio Thoracic Transplant Association, a section of ESOT

Maria Simonenko et al. Eur J Heart Fail. 2024 Sep.

Free article

. 2024 Sep;26(9):1876-1892.

doi: 10.1002/ejhf.3185. Epub 2024 Jun 19.

Authors

Affiliations

¹ Cardiopulmonary Exercise Test Research Department, Heart Transplantation Outpatient Department, V.A. Almazov National Medical Research Centre, St. Petersburg, Russia.
² REVAL and BIOMED Rehabilitation Research Center, Hasselt University, Hasselt, Belgium.
³ Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.
⁴ University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.
⁵ Cardio-Pulmonary Department, IRCCS San Raffaele Roma, Rome, Italy.
⁶ Heart Failure and Heart Transplantation Unit, Onassis Cardiac Surgery Center, Athens, Greece.
⁷ Department of Cardiac Surgery and Transplants, Monaldi Hospital, Azienda dei Colli, Naples, Italy.
⁸ Cardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital, Rivolta d'Adda (CR), Italy.
⁹ Department of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁰ University Hospital Germans Trias and Pujol de Badalona, Badalona, Spain.
¹¹ Heart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva and Sackler, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹² School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK.
¹³ Department of Translational Medicine, University of Naples 'Federico II', Naples, Italy.
¹⁴ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
¹⁵ Mediterranea Cardiocentro, Naples, Italy.
¹⁶ Emergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu', Bucharest, Romania.
¹⁷ University of Medicine Carol Davila, Bucharest, Romania.
¹⁸ Heart Research Institute, Sydney, NSW, Australia.
¹⁹ Cardiology Department, University of Paris, INSERM UMRS-942, Hopital Lariboisiere, AP-HP, Paris, France.
²⁰ Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
²¹ Department of Cardiology, Ramón y Cajal University Hospital, Madrid, Spain.
²² Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium.
²³ Department of Cardiology, Antwerp University Hospital, Edegem, Belgium.
²⁴ Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
²⁵ Department of Cardiology, Maxima Medical Centre, Eindhoven, The Netherlands.
²⁶ Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands.
²⁷ School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
²⁸ Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden.
²⁹ Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands.
³⁰ Wroclaw Medical University, Wroclaw, Poland.
³¹ Department of Cardiology, Mater University Hospital, Dublin, Ireland.
³² School of Medicine, University College Dublin, Dublin, Ireland.
³³ Universitätsmedizin Berlin Campus Benjamin Franklin Klinik für Kardiologie Charite, Berlin, Germany.
³⁴ General Hospital Murska Sobota, Murska Sobota, Slovenia.
³⁵ Department of Medicine, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
³⁶ Armed Forces Hospital, Porto, Portugal.
³⁷ Centre for Health Technologies and Services Research, Faculty of Medicine of University of Porto, Porto, Portugal.
³⁸ Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
³⁹ Division of Physiology and Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria.
⁴⁰ Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
⁴¹ Dipartimento Scienze Biomediche per la Salute, Universita' Degli Studi di Milan, Milan, Italy.
⁴² Cardiologia Universitaria, IRCCS Policlinico San Donato, Milan, Italy.
⁴³ University Hospital of Bologna, Bologna, Italy.
⁴⁴ Department of Cardiology, Scientific Institution of Cardiology and Internal Diseases, Almaty, Kazakhstan.
⁴⁵ Department of Cardiology, Kapshagai City Hospital, Almaty, Kazakhstan.
⁴⁶ St. George's Hospital NHS Trust University of London, London, UK.
⁴⁷ Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
⁴⁸ Faculty of Medicine and Heart Failure Center, University of Belgrade, Belgrade University Medical Center, Belgrade, Serbia.
⁴⁹ Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School and Fraunhofer Institute for Toxicology and Experimental Research, Hannover, Germany.

PMID: 38894693
DOI: 10.1002/ejhf.3185

Abstract

Little is known either about either physical activity patterns, or other lifestyle-related prevention measures in heart transplantation (HTx) recipients. The history of HTx started more than 50 years ago but there are still no guidelines or position papers highlighting the features of prevention and rehabilitation after HTx. The aims of this scientific statement are (i) to explain the importance of prevention and rehabilitation after HTx, and (ii) to promote the factors (modifiable/non-modifiable) that should be addressed after HTx to improve patients' physical capacity, quality of life and survival. All HTx team members have their role to play in the care of these patients and multidisciplinary prevention and rehabilitation programmes designed for transplant recipients. HTx recipients are clearly not healthy disease-free subjects yet they also significantly differ from heart failure patients or those who are supported with mechanical circulatory support. Therefore, prevention and rehabilitation after HTx both need to be specifically tailored to this patient population and be multidisciplinary in nature. Prevention and rehabilitation programmes should be initiated early after HTx and continued during the entire post-transplant journey. This clinical consensus statement focuses on the importance and the characteristics of prevention and rehabilitation designed for HTx recipients.

Keywords: Diabetes; Dyslipidaemia; Exercise training; Heart failure; Heart transplantation; Hypertension; Physical activity; Prevention; Primary prevention; Rehabilitation; Risk factors; Secondary prevention.

© The Authors. Published by John Wiley & Sons Limited and Oxford University Press on behalf of the European Society of Cardiology, and Frontiers Media SA on behalf of the European Society for Organ Transplantation.

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Yao D, Qian S, Xu L, Fan L, Li F, Chen S, Shi J, Dong N. Yao D, et al. BMC Cardiovasc Disord. 2024 Oct 16;24(1):563. doi: 10.1186/s12872-024-04231-0. BMC Cardiovasc Disord. 2024. PMID: 39407105 Free PMC article.

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Prevention and rehabilitation after heart transplantation: A clinical consensus statement of the European Association of Preventive Cardiology, Heart Failure Association of the ESC, and the European Cardio Thoracic Transplant Association, a section of ESOT

Affiliations

Prevention and rehabilitation after heart transplantation: A clinical consensus statement of the European Association of Preventive Cardiology, Heart Failure Association of the ESC, and the European Cardio Thoracic Transplant Association, a section of ESOT

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