Postoperative exercise tolerance after aortic valve replacement by small-size prosthesis
| Autor: | Christian Préfaut, Paul-André Chaptal, Eric Arnaud, Robert Grolleau, Florence Leclercq, Pierre Becassis, Jerome Brunet, Jean-Marc Frapier, Maurice Hayot, P. Messner-Pellenc, Jean-Marc Davy, Lionel Beck |
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| Rok vydání: | 2000 |
| Předmět: |
Aortic valve
medicine.medical_specialty Ejection fraction business.industry medicine.medical_treatment VO2 max Cardiorespiratory fitness Physical exercise Exercise intolerance medicine.disease Surgery medicine.anatomical_structure Valve replacement Aortic valve replacement Internal medicine Cardiology Medicine medicine.symptom business Cardiology and Cardiovascular Medicine |
| Zdroj: | Journal of the American College of Cardiology. 36(3):871-877 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/s0735-1097(00)00815-9 |
| Popis: | OBJECTIVES The objective of this study was to determine whether a small-size valve prosthesis contributes to exercise intolerance, as assessed by V o 2 measurement during an exhaustive cycle ergometer exercise. BACKGROUND The determinants of exercise capacity after mechanical aortic replacement are not well known. The selection of small valve sizes has, however, been described as an independent predictor of exercise intolerance as assessed by exercise duration. Maximal oxygen uptake (V o 2 max) is a good index of exercise tolerance. METHODS Fourteen patients were eligible, with a mean age of 62 ± 6 years. Before surgery, the mean left ventricular ejection fraction (LVEF) was 73 ± 8%. Two valve types with small diameter (19 to 21 mm) were used: Medtronic Hall and St Jude Medical. A healthy sedentary control group (n = 14) paired for age, weight and size was constituted. After one year of follow-up, cardiorespiratory tests were performed. In addition, the gradients through the prostheses were determined by continuous pulse Doppler at rest and immediately after the cardiorespiratory test. RESULTS The exercise tolerance was not significantly different between the control group and patient group: V o 2 peak (21.7 vs. 20.4 ml/kg/min; p = 0.42), workloads (115 vs. 93 W; p = 0.13) and ventilatory parameters were similar. The mean and peak gradients at rest and during exercise were not correlated with V o 2max. CONCLUSIONS Valve replacement by small aortic prosthesis does not seem to be a factor of exercise intolerance as assessed by V o 2 max in patients without LVEF dysfunction before surgery. |
| Databáze: | OpenAIRE |
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