Improvement in hemodynamic parameters is routinely demonstrated in patients implanted with continuous-flow left ventricular assist devices (CF-LVADs). However, functional capacity assessed by cardiopulmonary exercise test (CPET), following LVAD implantation, remains considerably restricted. In this review, we analyzed the current knowledge on the causes of the persistent limitation in exercise capacity in CF-LVAD patients. Limitation to exercise is multifactorial and involves: LVAD factors (fixed CF-LVAD pump speed), native cardiac factors (residual function of native left ventricle, right ventricular dysfunction, aortic valve abnormalities), comorbidities (abnormal skeletal muscle metabolism, low skeletal muscle mass, anemia), patient's characteristics (age, physical deconditioning). In addition, we emphasize the role of some potential therapeutic strategies like the increase in CF-LVAD pump speed according to the patient's activity, the echo-optimization of the device (paying attention to right ventricular function and aortic valve opening), the implementation of physical rehabilitation and the treatment of potentially reversible extracardiac factors (anemia, muscle deconditioning, obesity).

植入了连续流左心室辅助装置（CF-LVADs）的患者中常规表现出血液动力学参数的改善。但是，LVAD植入后通过心肺运动试验（CPET）评估的功能能力仍然受到很大限制。在这篇综述中，我们分析了CF-LVAD患者运动能力持续受限的原因的最新知识。运动受限是多因素的，并且涉及：LVAD因素（固定的CF-LVAD泵速度），天然心脏因素（天然左心室残余功能，右心室功能障碍，主动脉瓣异常），合并症（骨骼肌代谢异常，骨骼肌质量低下，贫血），患者特征（年龄，身体不适）。此外，我们强调了一些潜在的治疗策略的作用，例如根据患者的活动增加CF-LVAD泵的速度，设备的回波优化（注意右心室功能和主动脉瓣的打开），身体康复和潜在的可逆心外因素（贫血，肌肉萎缩，肥胖）的治疗。