- Suboptimal post-operative improvements in functional capacity are often observed after minimally invasive aortic valve replacement (mini-AVR). It remains to be studied how AVR affects the cardiopulmonary and skeletal muscle function during exercise to explain these clinical observations and to provide a basis for improved/tailored post-operative rehabilitation. Twenty two patients with severe aortic stenosis (AS) (aortic valve area (AVA) < 1.0 cm(2)) were preoperatively compared to 22 healthy controls during submaximal constant-workload endurance-type exercise for oxygen uptake (V-O2), carbon dioxide output (V-CO2), respiratory gas exchange ratio, expiratory volume (V-E), ventilatory equivalents for O-2 (V-E/V-O2) and CO2 (V-E/V-CO2), respiratory rate (RR), tidal volume (V-t), heart rate (HR), oxygen pulse (V-O2/HR), blood lactate, Borg ratings of perceived exertion (RPE) and exercise-onset V-O2 kinetics. These exercise tests were repeated at 5 and 21 days after AVR surgery (n = 14), along with echocardiographic examinations.Suboptimal post-operative improvements in functional capacity are often observed after minimally invasive aortic valve replacement (mini-AVR). It remains to be studied how AVR affects the cardiopulmonary and skeletal muscle function during exercise to explain these clinical observations and to provide a basis for improved/tailored post-operative rehabilitation. Twenty two patients with severe aortic stenosis (AS) (aortic valve area (AVA) < 1.0 cm(2)) were preoperatively compared to 22 healthy controls during submaximal constant-workload endurance-type exercise for oxygen uptake (V-O2), carbon dioxide output (V-CO2), respiratory gas exchange ratio, expiratory volume (V-E), ventilatory equivalents for O-2 (V-E/V-O2) and CO2 (V-E/V-CO2), respiratory rate (RR), tidal volume (V-t), heart rate (HR), oxygen pulse (V-O2/HR), blood lactate, Borg ratings of perceived exertion (RPE) and exercise-onset V-O2 kinetics. These exercise tests were repeated at 5 and 21 days after AVR surgery (n = 14), along with echocardiographic examinations. Respiratory exchange ratio and ventilatory equivalents (V-E/V-O2 and V-E/V-CO2) were significantly elevated, V-O2 and V-O2/HR were significantly lowered, and exercise-onset V-O2 kinetics were significantly slower in AS patients vs. healthy controls (P < 0.05). Although the AVA was restored by mini-AVR in AS patients, V-E/V-O2 and V-E/V-CO2 further worsened significantly within 5 days after surgery, accompanied by elevations in Borg RPE, V-E and RR, and lowered V-t. At 21 days after mini-AVR, exercise-onset V-O2 kinetics further slowed significantly (P < 0.05). A decline in pulmonary function was observed early aftermini-AVRsurgery, which was followed by a decline in skeletal muscle function in the subsequent weeks of recovery. Therefore, a tailored rehabilitation programmeshould include training modalities for the respiratory and peripheral muscular system.…
MetadatenVerfasserangaben: | Hajar Boujemaa, Alaaddin Yilmaz, Boris Robic, Katrien KoppoORCiD, Guido Claessen, Ines Frederix, Paul Dendale, Heinz VöllerORCiDGND, Luc J. C. van Loon, Dominique HansenORCiD |
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DOI: | https://doi.org/10.1113/EP087407 |
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ISSN: | 0958-0670 |
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ISSN: | 1469-445X |
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Pubmed ID: | https://pubmed.ncbi.nlm.nih.gov/30938881 |
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Titel des übergeordneten Werks (Englisch): | Experimental physiology |
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Verlag: | Wiley |
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Verlagsort: | Hoboken |
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Publikationstyp: | Wissenschaftlicher Artikel |
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Sprache: | Englisch |
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Datum der Erstveröffentlichung: | 02.04.2019 |
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Erscheinungsjahr: | 2019 |
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Datum der Freischaltung: | 26.01.2021 |
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Freies Schlagwort / Tag: | aortic valve stenosis; exercise tolerance; surgery |
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Band: | 104 |
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Ausgabe: | 6 |
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Seitenanzahl: | 11 |
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Erste Seite: | 855 |
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Letzte Seite: | 865 |
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Fördernde Institution: | Hartcentrum Hasselt, vzw (Belgium) |
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Organisationseinheiten: | Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Psychologie |
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DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Peer Review: | Referiert |
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Publikationsweg: | Open Access / Green Open-Access |
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