Document Detail


Effect of mitral valve repair on exercise tolerance in asymptomatic patients with organic mitral regurgitation.
MedLine Citation:
PMID:  17584574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of the study was to quantify the changes in cardiopulmonary function after minimally invasive video-assisted mitral valve repair for organic mitral regurgitation (MR) in asymptomatic or minimally symptomatic patients. METHODS: Twenty-six patients (age 54 +/- 11 years) with severe organic MR (regurgitant volume of 94 +/- 37 mL, effective regurgitant orifice [ERO] of 0.73 +/- 0.35 cm2) and mild or no symptoms (New York Heart Association class 1.2 +/- 0.4) underwent exercise echocardiography and cardiopulmonary exercise testing 1 week before and 4 months after uncomplicated video-assisted mitral valve repair. RESULTS: During exercise, left ventricular ejection fraction increased from 68% +/- 7% to 74% +/- 6% (P < .0001), but ERO did not change significantly. Four months after video-assisted mitral valve repair, a significant improvement was observed in peak oxygen uptake (VO2max from 23 +/- 6 to 25 +/- 7 mL x kg(-1) x min(-1), P < .001), peak oxygen pulse (11 +/- 3 to 12 +/- 4 mL per beat, P < .005) as well as in maximal workload (from 143 +/- 49 to 159 +/- 55 W, P < .0001). When only patients without any symptoms (New York Heart Association class I, n = 20) were considered, these changes were even more pronounced (VO2max from 24 +/- 7 to 27 +/- 7 mL x kg(-1) x min(-1), P < .001). Post-operative changes in VO2max correlated with preoperative exercise-induced contractile reserve (r = 0.72, P < .0001), preoperative ERO (r = 0.49, P < .05), and preoperative ejection fraction at rest (r = 0.42, P < .05). CONCLUSION: In patients with severe organic MR but mild or no symptoms, cardiopulmonary performance improves after successful minimally invasive video-assisted mitral valve repair. Improvement is directly related to preoperative left ventricular function and contractile reserve.
Authors:
Juraj Madaric; Patrick Watripont; Jozef Bartunek; Filip Casselman; Marc Vanderheyden; Frank Van Praet; William Wijns; Ann Feys; Hugo Vanermen; Bernard De Bruyne
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  154     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-22     Completed Date:  2007-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  180-5     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Echocardiography, Doppler
Echocardiography, Stress
Exercise Test
Exercise Tolerance*
Female
Heart Function Tests
Humans
Male
Middle Aged
Mitral Valve Insufficiency / physiopathology*,  surgery*,  ultrasonography
Postoperative Period
Quality of Life
Thoracic Surgery, Video-Assisted
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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