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European Heart Journal 1997 18(3):464-469;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Physical training improves exercise capacity in patients with mitral stenosis after balloon valvuloplasty

H. Douard, L. Chevalier, L. Labbe, A. Choussat and J. P. Broustet

Hôpital Cardiologique du Haut Lévèque Pessac, France

Received 20 September 1996; accepted 25 September 1996.

Correspondence: Dr H. Douard, Hôpital Cardiologique du Haut Lévèque, 33604 Pessac, France

Abstract

BACKGROUND: Haemodynamic measurements taken at rest and during exercise showed that percutaneous transvenous mitral commissurotomy results in both acute and long-term improvement. However, the time lag before there is an increase in exercise and in peak oxygen uptake appears to be delayed and irregular.

PATIENTS AND METHODS: To assess the potential of physical training to restore better physical capacity after percutaneous transvenous mitral commissurotomy, 26 patients with mitral stenosis were studied after the procedure. The group was split into two. Thirteen underwent a 3-month rehabilitation programme, and the other 13, who did not, acted as controls.

RESULTS: The mitral valve orifice area increased similarly, from 1·;12±017 to 1·88 ±0·28 cm2 in the training group and from 1·04±0·16 to 1·88±0·19 cm2 in the control group. Cardiopulmonary parameters were similar before percutaneous transvenous mitral commissurotomy (peak o2: 19·9±2·4 vs 18·9±4·5 ml. min–1. kg–1; peak workload: 94·6±29·3 vs 96·1±25 watts; o2 at anaerobic threshold: 17±3·4 vs 16·1±5·2 ml. .min–1. kg–1; all P=ns). Three months later the results were higher in the training group (peak o2: 26·6±4·7 vs 21·6±3·8 ml. min–1. kg–1, P=0·001; peak workload: 125·4±26·6 vs 108·5±23 watts, p=0·03; o2 at anaerobic threshold: 19·6±5·8 vs 15·8±2·9 ml. min–1. kg–1; P=0·02).

CONCLUSION: These results indicate that patients should take up exercise after successful percutaneous transvenous mitral commissurotomy for better functional improvement.

Key Words: Physical training • mitral valvuloplasty • exercise


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