Περίληψη:
To determine the preoperative and postoperative effect of atrial
fibrillation (AF) on exercise capacity in mitral stenosis, 12
digitalized patients in AF (7 women and 5 men, age 52 +/- 6.1 years) and
10 in sinus rhythm (5 women and 5 men, age 46 +/- 5 years) underwent
maximal cardiopulmonary exercise testing according to Weber’s protocol
and Doppler echocardiographic examination before and at 3 and 6 months
after mitral valve replacement. The ratio of right ventricular
acceleration to ejection time was used as an estimate of mean pulmonary
artery pressure, Preoperative exercise duration (6.8 +/- 1 vs 8 +/- 2
minutes), peak oxygen consumption (9.7 +/- 3 vs 12.3 +/- 3 ml/kg/min),
and right ventricular acceleration to ejection time ratio (0.34 +/- 0.07
vs 0.34 +/- 0.08) were not significantly different between patients with
AF and those in sinus rhythm, Postoperative improvement in these
parameters was lower in patients with AF than in those in sinus rhythm:
exercise duration at 3 months, 7.5 +/- 2 vs 11.9 +/- 2 minutes (p <
0.001); at 6 months, 9 +/- 2 vs 12 +/- 2 minutes (9 < 0.001); peak
oxygen consumption at 3 months, 10.8 +/- 3 vs 17.5 +/- 3 ml/kg/min (9 <
0.001); and at b months, 11,9 +/- 3 vs 17.8 +/- 3 ml/kg/min (9 < 0.001);
right ventricular deceleration to ejection time ratio at 3 months, 0.35
+/- 0.08 vs 0.42 +/- 0.05 (p < 0.05); and at 6 months, 0.38 +/- 0.05 vs
0.44 +/- 0.05 (p < 0.05). Peak oxygen: consumption was directly related
to right acceleration to ejection time ratio both in patients with AF (r
= 0.67) and in those in sinus rhythm (r = 0.77), Thus, AF is not
associated with a further decrease in exercise capacity in digitalized
patients with severe mitral stenosis but adversely affects the
postoperative improvement in their exercise capacity after mitral valve
replacement.
Συγγραφείς:
TRIPOSKIADIS, F
TRIKAS, A
TENTOLOURIS, K
PITSAVOS, C and
CHLAPOUTAKIS, E
KYRIAKIDIS, M
GIALAFOS, J
TOUTOUZAS, P
