Document Detail


Mechanism of improvement in exercise capacity after the maze procedure combined with mitral valve surgery.
MedLine Citation:
PMID:  14676246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To clarify the mechanism of improvement in exercise capacity after the maze procedure.
DESIGN: Retrospective study.
SETTING: Tertiary referral centre.
PATIENTS: 26 patients (mean (SD) age 57 (9) years) with atrial fibrillation (AF) and mitral valve disease were studied with echocardiography and cardiopulmonary exercise testing before and after the maze procedure combined with mitral valve surgery. Of these, eight had persistent AF and 18 had restored sinus rhythm (SR) by the surgery. Six patients (mean (SD) age 59 (12) years) with AF undergoing mitral valve surgery without the maze procedure who had cardiopulmonary exercise testing before and after the surgery formed the control group.
MAIN OUTCOME MEASURES: Echocardiographic parameters of atrial function were measured from transmitral flow recordings. Peak oxygen uptake (VO2) and the slope of the relation between VO2 and workload (ratio of DeltaVO2 to Delta work) were determined as indices of exercise capacity.
RESULTS: The degree of improvements in peak VO2 and the ratio of DeltaVO2 to Delta work after the mitral valve surgery was comparable between the maze and control group. It was also comparable between patients with and those without successfully restored SR after the maze procedure. The degree of the increase in peak VO2 correlated with the change in left atrial diameter (r = -0.40, p = 0.047) but atrial contraction did not correlate with the increase.
CONCLUSIONS: Improvement in exercise capacity may not be caused by restored SR and atrial contraction but may at least partly relate to the reduction of left atrial size and improvement of haemodynamic variables by the surgery.
Authors:
S Yuda; S Nakatani; Y Kosakai; T Satoh; Y Goto; M Yamagishi; K Bando; S Kitamura; K Miyatake
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  90     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-16     Completed Date:  2004-01-20     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  64-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, National Cardiovascular Centre, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / physiopathology,  surgery*
Atrial Function
Echocardiography, Doppler
Electrocardiography
Exercise Test
Exercise Tolerance*
Female
Humans
Male
Middle Aged
Mitral Valve Insufficiency / physiopathology,  surgery*
Mitral Valve Stenosis / physiopathology,  surgery*
Oxygen Consumption
Postoperative Care
Retrospective Studies
Treatment Outcome
Comments/Corrections

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