CEPA Webinar: Left Ventricular Assistant Devices with Exercise Ramp Protocols

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CEPA Webinar: Left Ventricular Assistant Devices with Exercise Ramp Protocols

Presenter: Jeffrey W. Christle, PHD

Left ventricular assist devices (LVAD) are mechanical pumps that increase vascular circulation of blood in patients with severe heart failure, in which native ventricular function is insufficient. VADs are increasingly being used for patients with end stage heart failure as a bridge-to-transplantation, destination therapy and bridge-to-recovery. Assessment of LV and cardiopulmonary function in these patients is challenging, but feasible and imperative to successful treatment. VAD Ramping is a technique in which cardiac ultrasound is used to assess LV function with the VAD at high (therapeutic) and low (non-therapeutic) speeds. This technique allows the clinician to investigate native resting LV function as well as the contribution of VAD therapy to resting LV function. Cardiopulmonary exercise testing (CPX) is the most common technique for assessing global cardiopulmonary function, including peak oxygen uptake (VO2peak) and ventilatory efficiency (VE/VCO2 slope). VO2peak and VE/VCO2 slope are very powerful prognostic metrics in heart failure. Combining VAD Ramping with CPX is a novel application of known methods to assess LV and cardiopulmonary function simultaneously, with and without VAD therapy.

Dr. Jeffrey Christle is a clinical exercise physiologist who started his physiology career at the University of Massachusetts in Amherst working as an undergraduate research assistant in muscle physiology. He is an internationally recognized expert in clinical exercise physiology and exercise testing, and prescriptions for individuals with and without cardiovascular disease.

Dr. Christle’s scientific experience included several large-scale clinical research trials on the effects of exercise in patients with heart disease and he has published several papers on the subject. His current research interests include exercise testing and prescription in severe heart failure, the application of wearable technology to the clinical assessment and management of cardiovascular disease and the investigation of novel biomarkers for the detection of early disease. He completed his PhD in Munich, Germany in January 2016, and was recruited to join the Division of Cardiovascular Medicine at Stanford University. He is responsible for the Adult Cardiopulmonary Exercise Testing Laboratory. Dr. Christle is a member and collaborator of the Stanford Center for Inherited Cardiovascular Disease (SCICD), Stanford Biomarker and Phenotyping Core Laboratory (BPCL), and Stanford Sports Cardiology (SC2).

He is an avid soccer player and fan. His current exercise routine consists of 45-60 minutes of daily bicycle commuting, playing exhaustively with his two young daughters, and occasional tennis.

Available Course Credits


Learning Objectives

  1. Learn how to safely and effectively perform a CPX in patients being considered for LVAD explant.
  2. Learn how CPX yields important data in the assessment of LV recovery.
  3. Learn how to how CPX adds more value to the analysis than when those studies are performed separately.
  4. Learn how to use of LVAD-CPX-Ramping as a tool for exercise prescription in this population.


Course Content

CEPA Webinar: Left Ventricular Assistant Devices with Exercise Ramp Protocols - Video
CEPA Webinar: Left Ventricular Assistant Devices with Exercise Ramp Protocols - Test