PHYSICAL-TRAINING IMPROVES EXERCISE CAPACITY IN PATIENTS WITH MITRAL-STENOSIS AFTER BALLOON VALVULOPLASTY

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 th ere is an increase in exercise and in peak oxygen uptake appears to be delayed and irregular. Patients and methods To assess the potential o f physical training to restore better physical capacity after percutan eous transvenous mitral commissurotomy, 26 patients with mitral stenos is were studied after the procedure. The group was split into two. Thi rteen 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 cm(2) in the training group and from 1.04 +/- 0.16 to 1.88 +/- 0.19 cm(2) in the co ntrol group. Cardiopulmonary parameters were similar before percutaneo us transvenous mitral commissurotomy (peak VO2: 19.9 +/- 24 vs 189 +/- 4.5 ml.min(-1).kg(-1); peak workload: 94.6 +/- 29.3 vs 96.1 +/- 25 wa tts; 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=0.001; 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). Conclusion These results indicate that patients s hould take up exercise after successful percutaneous transvenous mitra l commissurotomy for better functional improvement.