title: Physical training improves exercise capacity in patients with mitral stenosis after balloon valvuloplasty.
abstract: BACKGROUND
  Haemodynamic measurements taken at rest and during exercise showed that percutaneous transvenous mitral commissurotomy results in both acute and long-term improvement. However, the time lag before there is an increase in exercise and in peak oxygen uptake appears to be delayed and irregular.
  
  
  METHODS
  To assess the potential of physical training to restore better physical capacity after percutaneous transvenous mitral commissurotomy, 26 patients with mitral stenosis were studied after the procedure. The group was split into two. Thirteen underwent a 3-month rehabilitation programme, and the other 13, who did not, acted as controls.
  
  
  RESULTS
  The mitral valve orifice area increased similarly, from 1.12 +/- 0.17 to 1.88 +/- 0.28 cm2 in the training group and from 1.04 +/- 0.16 to 1.88 +/- 0.19 cm2 in the control group. Cardiopulmonary parameters were similar before percutaneous transvenous mitral commissurotomy (peak VO2: 19.9 +/- 2.4 vs 18.9 +/- 4.5 ml. min-1.kg-1; peak workload: 94.6 +/- 29.3 vs 96.1 +/- 25 watts; VO2 at anaerobic threshold: 17 +/- 3.4 vs 16.1 +/- 5.2 ml.min-1.kg-1; all P = ns). Three months later the results were higher in the training group 1 (peak VO2: 26.6 +/- 4.7 vs 21.6 +/- 3.8 ml.min-1.kg-1, P = 0.03; peak workload: 125.4 +/- 26.6 vs 108.5 +/- 23 watts, P = 0.03; VO2 at anaerobic threshold: 19.6 +/- 5.8 vs 15.8 +/- 2.9 ml.min-1.kg-1; P = 0.02).
  
  
  CONCLUSIONS
  These results indicate that patients should take up exercise after successful percutaneous transvenous mitral commissurotomy for better functional improvement.
authors.affiliation: Hôpital Cardiologique du Haut Lévèque, Pessac, France.
authors.forename: H
authors.initials: H
authors.lastname: Douard
authors.forename: L
authors.initials: L
authors.lastname: Chevalier
authors.forename: L
authors.initials: L
authors.lastname: Labbe
authors.forename: A
authors.initials: A
authors.lastname: Choussat
authors.forename: J P
authors.initials: JP
authors.lastname: Broustet
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D002404:Catheterization; D004562:Electrocardiography; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy*; D011446:Prospective Studies; D013997:Time Factors