Physical training improves exercise capacity in patients with mitral stenosis after balloon valvuloplasty

Abstract

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 there is an increase in exercise and in peak oxygen uptake appears to be delayed and irregular.

Patients and methods: To assess the potential of physical training to restore better physical capacity after percutaneous transvenous mitral commissurotomy, 26 patients with mitral stenosis were studied after the procedure. The group was split into two. Thirteen 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 cm2 in the training group and from 1.04 +/- 0.16 to 1.88 +/- 0.19 cm2 in the control group. Cardiopulmonary parameters were similar before percutaneous transvenous mitral commissurotomy (peak VO2: 19.9 +/- 2.4 vs 18.9 +/- 4.5 ml. min-1.kg-1; peak workload: 94.6 +/- 29.3 vs 96.1 +/- 25 watts; 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 = 0.03; 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 should take up exercise after successful percutaneous transvenous mitral commissurotomy for better functional improvement.