Document Detail

Effects of aortic valve replacement on exercise duration and functional status in adults with valvular aortic stenosis.
MedLine Citation:
PMID:  9141965     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effect of aortic valve replacement on left ventricular function, functional status and exercise duration in an adult population with valvular aortic stenosis. DESIGN: Prospective study of initially asymptomatic patients with pre- and postvalve replacement echocardiography, functional status score and exercise data. SETTING: University-affiliated, tertiary care teaching hospital. PATIENTS: Valvular aortic stenosis patients referred from academic and private practice internists and cardiologists (n = 34, 65% men, mean age 68 +/- 11 years, preoperative aortic valve area 0.9 +/- 0.4 cm2). INTERVENTIONS: Annual Doppler echocardiography, functional status questionnaires and, if possible, Bruce protocol maximal exercise tolerance tests. MAIN RESULTS: Aortic valve replacement resulted in a decrease in maximum jet velocity (pre 4.7 +/- 0.7 versus post 2.9 +/- 0.7 m/s, P = 0.0001) and left ventricular mass (pre 167 +/- 37 versus post 134 +/- 32 g, P = 0.0001) and an increase in left ventricular ejection fraction (pre 65 +/- 11 versus post 69 +/- 10%, P = 0.05) at rest. However, there was no change in the ratio of early to atrial diastolic filling velocities (pre 1.2 +/- 0.5 versus post 1.4 +/- 0.8, not significant), exercise tolerance as assessed by estimated functional aerobic impairment (pre 26 +/- 32 versus post 22 +/- 27%, not significant) or functional status score (pre 89 +/- 13 versus post 91 +/- 11, not significant). CONCLUSIONS: When the aortic valve is replaced promptly at symptom onset, despite improvement in resting left ventricular systolic performance, there is no evidence of improvement in exercise capacity or functional status.
B I Munt; M E Legget; N L Healy; M Fujioka; R Schwaegler; C M Otto
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  13     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-20     Completed Date:  1997-05-20     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  346-50     Citation Subset:  IM    
Department of Medicine, University of Washington, Seattle 98195, USA.
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MeSH Terms
Aortic Valve Stenosis / pathology,  physiopathology*,  surgery*,  ultrasonography
Echocardiography, Doppler
Exercise Test*
Heart Valve Prosthesis*
Heart Ventricles / pathology
Middle Aged
Prospective Studies
Time Factors
Treatment Outcome
Ventricular Function, Left*

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

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