Early exercise training after mitral valve repair: a multicentric prospective French study.
BACKGROUND
Surgical mitral valve (MV) repair is now the best technique to correct mitral regurgitation (MR). However, clinical studies have shown that without exercise training (ET), there is no significant postoperative exercise tolerance improvement. Moreover, healing duration of the MV wound is not well known; thus, the feasibility of an early ET program (ETP) may be discussed.


OBJECTIVE
To evaluate safety and feasibility of an early ETP after MV repair.


RESULTS
All patients hospitalized in 13 postoperative centers after MV repair from September 2002 to June 2003 were included in this prospective study. They underwent an ETP during 3 weeks on average. Transthoracic echocardiography and a cardiopulmonary exercise test were performed before and after the ETP.


METHODS
Two hundred fifty-one consecutive patients (male gender, 70%; mean age, 59 +/- 14 years [+/- SD]) were included 16 +/- 10 days after MV repair. There was no MR occurrence or worsening after the ETP. Left ventricular ejection fraction slightly increased (53 +/- 10% vs 55 +/- 9%, p = 0.004). Peak oxygen consumption and anaerobic threshold increased from 16.3 +/- 4.5 to 20.0 +/- 6.0 mL/kg/min (22% increase) and from 12.2 +/- 3.8 to 14.2 +/- 4.3 mL/kg/min (16% increase) respectively, (p < 0.0001).


CONCLUSIONS
ET after MV repair does not deteriorate the outcome of recent surgery and seems efficient.
Meurin
Philippe
P
Les Grands Prés, Centre de Réadaptation Cardiaque de la Brie, 27 rue Sainte Christine, 77174 Villeneuve Saint Denis, France. philippemeurin@hotmail.com
Iliou
Marie Christine
MC
Ben Driss
Ahmed
A
Pierre
Bernard
B
Corone
Sonia
S
Cristofini
Pascal
P
Tabet
Jean Yves
JY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000534:rehabilitation* / Q000601:surgery; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome