[Evaluation of the correlation with preoperative left ventricular end-systolic volume index and postoperative exercise tolerance in the patient with aortic regurgitation].
Twenty-three male patients (49 +/- 11 years old) undergoing aortic valve replacement (AVR) for aortic regurgitation received the exercise tolerance test using bicycle ergometer at more than one year after AVR. Preoperative left ventricular end-systolic volume index (LVESVI) significantly correlated with tolerance time, peak VO2, anaerobic threshold (AT) during the exercise, and with serum noradrenaline (NAd) levels at rest. Then patients were divided into two groups: those with preoperative LVESVI < or = 70 ml/M2 (13 patients, group A), and those with LVESVI > 70 ml/M2 (10 patients, group B). All patient in group A achieved more than 75 W of the exercise, however only one in group B achieved this level. The increase of VO2 in group B with an increasing exercise was significantly suppressed compared to group A, and then, the peak VO2 levels in group B were significantly lower than in group A (A: 20.9 +/- 3.7, B: 11.4 +/- 3.9 ml/kg/min). In addition group B showed a less increase of AT levels (A: 10.6 +/- 2.9, B: 6.8 +/- 2.3 ml/kg/min). In contrast, serum lactate and NAd levels in group B increased significantly at 50 W of the exercise compared to group A (A: 12.5 +/- 3.7, 332.3 +/- 104.2; B: 17.5 +/- 5.7 mg/dl, 746.7 +/- 324.3 pg/ml, respectively) though a significant difference of NAd levels before the exercise was observed between the both groups (A: 173.7 +/- 34.2, B: 329.0 +/- 132.1). In conclusion, group A showed a better exercise tolerance physiologically and biochemically compared to group B.(ABSTRACT TRUNCATED AT 250 WORDS)
Minowa
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Second Department of Surgery, Yamagata University School of Medicine, Japan.
D000293:Adolescent; D000328:Adult; D015308:Anaerobic Threshold; D001022:Aortic Valve Insufficiency / Q000503:physiopathology* / Q000601:surgery; D005080:Exercise Test; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology*; D011184:Postoperative Period; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology*