title: Effect of mitral valve repair on cardiopulmonary exercise testing variables in patients with chronic mitral regurgitation.
abstract: BACKGROUND
  Mitral valve repair is the surgical procedure of choice for patients with chronic Mitral Regurgitation (MR). The good early and late results allow surgical indication before symptom onset. The cardiopulmonary exercise test (CPET) can objectively assess functional capacity, but little is known about the effect of surgery on their variables.
  
  
  OBJECTIVE
  Evaluate the effects of mitral repair on CPET variables in patients with chronic MR.
  
  
  METHODS
  A total of 47 patients with severe MR were selected; these patients underwent mitral valve repair and were submitted to CPET ± 30 days before surgery, as well as six to 12 months after the surgery.
  
  
  RESULTS
  There was predominance of functional class I or II NYHA in 30 (63.8%) and 34 patients (72.3%), respectively. A significant decrease in oxygen consumption (VO2) was observed after surgery, from 1,719 ± 571 to 1609 ± 428 mL min-1, p = 0.036. There was a decrease in Oxygen Uptake Efficiency Slope (OUES) from 1,857 ± 594 to 1763 ± 514, p = 0.073 and oxygen pulse (O2) increased after surgery, from 11.1 ± 3.2 to 11.9 ± 3, 2 mL.beat-1 (p = 0.003).
  
  
  CONCLUSIONS
  The mitral valve repair did not increase peak VO2 and OUES despite positive cardiac remodeling observed seven months after surgery. However, O2 pulse increased postoperatively, suggesting improved LV systolic performance. The CPET is a useful tool to assist in the medical management of patients with MR.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil. dtogna17@yahoo.com.br
authors.forename: Dorival Julio Della
authors.initials: DJ
authors.lastname: Togna
authors.forename: Alexandre Antônio da Cunha
authors.initials: AA
authors.lastname: Abizaid
authors.forename: Romeu Sérgio
authors.initials: RS
authors.lastname: Meneghelo
authors.forename: David Costa de Souza
authors.initials: DC
authors.lastname: Le Bihan
authors.forename: Auristela Isabel de Oliveira
authors.initials: AI
authors.lastname: Ramos
authors.forename: Samira Kaissar
authors.initials: SK
authors.lastname: Nasr
authors.forename: Felipe Souza
authors.initials: FS
authors.lastname: Maia
authors.forename: Zilda Machado
authors.initials: ZM
authors.lastname: Meneghelo
authors.forename: Amanda Guerra de Moraes
authors.initials: AG
authors.lastname: Sousa
mesh_terms: D002908:Chronic Disease; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010101:Oxygen Consumption / Q000502:physiology*; D012123:Pulmonary Ventilation / Q000502:physiology*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology*