Document Detail

Increase in peak oxygen uptake by restoration of atrial contraction in patients after percutaneous transvenous mitral commissurotomy.
MedLine Citation:
PMID:  7719499     Owner:  NLM     Status:  MEDLINE    
The aim of the present study was to determine the effect of sinus conversion after mitral commissurotomy on the exercise performance of patients with mitral stenosis (MS) and atrial fibrillation (Af). Electric cardioversion was attempted 10 days after successful balloon mitral commissurotomy in 32 patients with MS and Af. Both symptom-limited exercise tests with respiratory gas analysis and constant workload exercise tests with echo-Doppler examinations were performed before, five days and three months after mitral commissurotomy, and five days after successful sinus conversion. The balloon commissurotomy attenuated the increase in transmitral pressure gradient during exercise. However, no significant increase either in peak oxygen uptake (PVO2) or stroke volume were observed even three months after commissurotomy in patients with persistent Af. Sinus conversion was successful in 17 patients and PVO2 increased from 21.4 +/- 4.1 to 23.4 +/- 4.0 ml/min/kg (p < 0.01). The extent of the increase in PVO2 was related to the atrial contribution in transmitral flow (R2 = 0.39, y = 0.81x + 1.2). Sinus rhythm was maintained for three months in 14 of 17 patients. Increased PVO2 was also preserved in these patients. These results suggest that the sinus conversion after mitral commissurotomy has an effect on the exercise performance of patients with MS and Af.
J Tamai; T Yoshioka; S Yasuda; H Takaki; Y Okano; F Ishikura; S Nagata; K Miyatake; K Shimomura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  2     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1995-05-22     Completed Date:  1995-05-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  623-8     Citation Subset:  IM    
Department of Medicine, National Cardiovascular Center, Osaka, Japan.
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MeSH Terms
Atrial Fibrillation / physiopathology,  therapy,  ultrasonography
Atrial Function / physiology*
Balloon Dilatation*
Blood Pressure / physiology
Cardiac Output / physiology
Echocardiography, Doppler
Electric Countershock
Exercise Test
Heart Ventricles / ultrasonography
Middle Aged
Mitral Valve / physiopathology,  ultrasonography
Mitral Valve Stenosis / physiopathology,  therapy*,  ultrasonography
Myocardial Contraction / physiology*
Oxygen Consumption / physiology*
Physical Exertion / physiology
Stroke Volume / physiology
Ventricular Function, Left / physiology

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