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      Decreased aerobic capacity 4 years after aortic valve replacement in male patients operated upon for chronic aortic regurgitation

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          Abstract

          Exercise testing is underutilized in patients with valve disease. We have previously found a low physical work capacity in patients with aortic regurgitation 6 months after aortic valve replacement (AVR). The aim of this study was to evaluate aerobic capacity in patients 4 years after AVR, to study how their peak oxygen uptake (peakVO 2) had changed postoperatively over a longer period of time. Twenty-one patients (all men, 52 ± 13 years) who had previously undergone cardiopulmonary exercise testing (CPET) pre- and 6 months postoperatively underwent maximal exercise testing 49 ± 15 months postoperatively using an electrically braked bicycle ergometer. Breathing gases were analysed and the patients' physical fitness levels categorized according to Åstrand's and Wasserman's classifications. Mean peakVO 2 was 22·8 ± 5·1 ml × kg −1 × min −1 at the 49-month follow-up, which was lower than at the 6-month follow-up (25·6 ± 5·8 ml × kg −1 × min −1, P = 0·001). All but one patient presented with a physical fitness level below average using Åstrand's classification, while 13 patients had a low physical capacity according to Wasserman's classification. A significant decrease in peakVO 2 was observed from six to 49 months postoperatively, and the decrease was larger than expected from the increased age of the patients. CPET could be helpful in timing aortic valve surgery and for the evaluation of need of physical activity as part of a rehabilitation programme.

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          Most cited references25

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          Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology.

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            Aerobic work capacity in men and women with special reference to age.

            I Astrand (1959)
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              Current status of cardiac rehabilitation.

              Cardiac rehabilitation is increasingly recognized as an integral component of the continuum of care for patients with cardiovascular disease. Its application is a class I recommendation in most contemporary cardiovascular clinical practice guidelines. Despite the documentation of substantial morbidity and mortality benefits, cardiac rehabilitation services are vastly underutilized. The core components of cardiac rehabilitation have been delineated in detail. Implementation of newly available performance measures offers the potential to enhance referral to, enrollment in, and completion of cardiac rehabilitation.
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                Author and article information

                Journal
                Clin Physiol Funct Imaging
                Clin Physiol Funct Imaging
                cpf
                Clinical Physiology and Functional Imaging
                Blackwell Publishing Ltd (Oxford, UK )
                1475-0961
                1475-097X
                May 2012
                : 32
                : 3
                : 167-171
                Affiliations
                [1 ]Division of Cardiovascular Medicine, Department of Medical and Health Sciences, University of Linköping Sweden
                [2 ]Department of Cardiothoracic Surgery, Heart & Medicine Centre, Linköping Sweden
                [3 ]Department of Clinical Physiology, Heart and Medicine Centre, Linköping Sweden
                Author notes
                Kristofer Hedman, Division of Cardiovascular Medicine, Department of Medical and Health Sciences, University of Linköping, S-551 85 Linköping, Sweden E-mail: kristofer.hedman@ 123456liu.se
                Article
                10.1111/j.1475-097X.2011.01072.x
                3489036
                22487149
                23628a25-9659-42b6-b0af-aab6b2ccc061
                © 2011 The Authors. Clinical Physiology and Functional Imaging © 2011 Scandinavian Society of Clinical Physiology and Nuclear Medicine

                Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen

                History
                : 13 June 2011
                : 30 October 2011
                Categories
                Original Articles

                Anatomy & Physiology
                physical fitness,exercise test,physical capacity,aortic valve insufficiency,open heart surgery,cardiopulmonary exercise testing,peak oxygen uptake

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