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. 2004 Jan;90(1):64-9.
doi: 10.1136/heart.90.1.64.

Mechanism of improvement in exercise capacity after the maze procedure combined with mitral valve surgery

S Yuda  1 , S Nakatani, Y Kosakai, T Satoh, Y Goto, M Yamagishi, K Bando, S Kitamura, K Miyatake
Affiliations

Mechanism of improvement in exercise capacity after the maze procedure combined with mitral valve surgery

S Yuda et al. Heart. 2004 Jan.

Abstract

Objective: To clarify the mechanism of improvement in exercise capacity after the maze procedure.

Design: Retrospective study.

Setting: Tertiary referral centre.

Patients: 26 patients (mean (SD) age 57 (9) years) with atrial fibrillation (AF) and mitral valve disease were studied with echocardiography and cardiopulmonary exercise testing before and after the maze procedure combined with mitral valve surgery. Of these, eight had persistent AF and 18 had restored sinus rhythm (SR) by the surgery. Six patients (mean (SD) age 59 (12) years) with AF undergoing mitral valve surgery without the maze procedure who had cardiopulmonary exercise testing before and after the surgery formed the control group.

Main outcome measures: Echocardiographic parameters of atrial function were measured from transmitral flow recordings. Peak oxygen uptake (VO2) and the slope of the relation between VO2 and workload (ratio of DeltaVO2 to Delta work) were determined as indices of exercise capacity.

Results: The degree of improvements in peak VO2 and the ratio of DeltaVO2 to Delta work after the mitral valve surgery was comparable between the maze and control group. It was also comparable between patients with and those without successfully restored SR after the maze procedure. The degree of the increase in peak VO2 correlated with the change in left atrial diameter (r = -0.40, p = 0.047) but atrial contraction did not correlate with the increase.

Conclusions: Improvement in exercise capacity may not be caused by restored SR and atrial contraction but may at least partly relate to the reduction of left atrial size and improvement of haemodynamic variables by the surgery.

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Figures

Figure 1
Figure 1
Comparison of peak oxygen uptake (V̇O2) (left panel) and ratio of ΔV̇O2 to Δ work (right panel) between the control, maze-sinus rhythm (SR), and maze-atrial fibrillation (AF) groups before (open bars) and after (grey bars) surgery.
Figure 2
Figure 2
Correlation between increases in peak V̇O2 and changes in left atrial diameter after surgery. Open circles, maze-SR group; solid circles, maze-AF group.
See this image and copyright information in PMC

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References

    1. Gohlke-Bärwolf C, Gohlke H, Samek L, et al. Exercise tolerance and working capacity after valve replacement. J Heart Valve Dis 1992;1:189–95. - PubMed
    1. McKay CR, Kawanishi DT, Kotlewski A, et al. Improvement in exercise capacity and exercise hemodynamics 3 months after double-balloon, catheter balloon valvuloplasty treatment of patients with symptomatic mitral stenosis. Circulation 1988;77:1013–21. - PubMed
    1. Triposkiadis F, Trikas A, Tentolouris K, et al. Effects of atrial fibrillation on exercise capacity in mitral stenosis. Am J Cardiol 1995;76:282–6. - PubMed
    1. Trikas A, Papadopoulos P, Triposkiadis F, et al. Factors affecting the postoperative exercise capacity of patients with mitral stenosis and aortic regurgitation. Cardiology 1994;85:201–6. - PubMed
    1. Groves PH, Lewis NP, Ikram S, et al. Reduced exercise capacity in patients with tricuspid regurgitation after successful mitral valve replacement for rheumatic mitral valve disease. Br Heart J 1991;66:295–301. - PMC - PubMed

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