p-ISSN: 1300-0551
e-ISSN: 2587-1498

Melda Pelin Yargıç1, Zülfikare Işık Solak Görmüş2

1Sports Medicine Department, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
2Physiology Department, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey

Keywords: Heart transplantation, heart failure, exercise therapy, exercise tolerance


Heart transplantation is a life-saving treatment option for patients with end-stage heart failure. The improvement in exercise capacity of patients can vary to a great extent following transplant surgery. This review outlines the pathophysiology behind the changes in exercise capacity after heart transplantation. Reasons for exercise intolerance can be classified as central (cardiac) and peripheral (vascular and skeletal muscle). Cardiac mechanisms that limit exercise capacity are chronotropic incompetence due to denervation of the heart and diastolic dysfunction. Peripheral mechanisms are endothelial dysfunction and morphological alterations in the skeletal muscle. Some of the pathophysiological changes can be recovered with exercise therapy after the transplantation surgery. Research should be directed to reveal the safest and most effective exercise prescription to heart transplant recipients, targeting all of the mechanisms that contribute to exercise intolerance in a holistic approach.

Cite this article as: Yargic MP, Solak Gormus ZI. Pathophysiology of exercise capacity after heart transplantation. Turk J Sports Med. 2021;56(4):203-8; http://dx.doi.org/10.47447/tjsm.0529

Author Contributions

Concept - M.P.Y., Z.I.S.G.; Design - M.P.Y., Z.I.S.G.; Supervision - M.P.Y., Z.I.- S.G.; Literature Review - M.P.Y., Z.I.S.G.; Writing Manuscript - M.P.Y., Z.I.S.G.; Critical Reviews - M.P-.Y., Z.I.S.G.

Conflict of Interest

The authors declared no conflicts of interest with respect to authorship and/or publication of the article.

Financial Disclosure

The authors received no financial support for the research and/or publication of this article.