Surgical aortic valve replacement improved physical work capacity at 1 year, increasing median peak workload from 133 to 144 watts (p<0.001) and ventilatory threshold.
Cohort (n=30)
Does surgical aortic valve replacement improve maximal and submaximal physical capacity on cardiopulmonary exercise testing in patients with severe aortic stenosis?
Surgical aortic valve replacement significantly improves submaximal physical work capacity at 1 year, and the oxygen uptake efficacy slope (OUES) may serve as a reliable surrogate for peak VO2 in severe aortic stenosis patients.
Absolute Event Rate: 144% vs 133%
p-value: p=<0.001
Background Knowledge about how patients with symptomatic aortic stenosis (AS) perform on cardiopulmonary exercise testing (CPET) is sparse. Since exercise testing in patients with symptomatic AS is not advised, submaximal parameters could be of special interest. We aimed to investigate maximal and submaximal physical capacity by CPET before and 1 year after surgical aortic valve replacement (sAVR) in patients with severe AS. Methods In this prospective longitudinal study, 30 adult patients (age 66±10 years) with severe AS referred for sAVR underwent maximal CPET (respiratory exchange ratio ≥1.05) on a bicycle ergometer before (PRE) and 1 year after (POST) sAVR. Normally distributed data are presented as mean (±SD) and non-normally distributed data are presented as median (IQR). Results Median peak workload increased by 8% from 133 (55) watts at PRE to 144 (67) watts at POST (p<0.001). Median ventilatory threshold (VO 2 @VT) increased from 1216 (391) to 1328 (309) mL/min (p=0.001, n=28). Mean peak oxygen uptake (peakVO 2 ) was not significantly different between PRE and POST; 1871±441 vs 1937±404 mL/min (p=0.08). The oxygen uptake efficacy slope (OUES) was significantly correlated to PeakVO2 at both PRE (r=0.889, p<0.05) and POST (r=0.888, p<0.05) Conclusion Physical work capacity was improved 1 year following sAVR, in terms of higher median peak workload and VO 2 @VT. The strong correlation between the submaximal variable OUES and peakVO 2 suggests that OUES might be a useful surrogate of peakVO 2 in this group of patients where maximal exercise testing is not always recommended.
Bellander et al. (Fri,) conducted a cohort in severe aortic stenosis (n=30). surgical aortic valve replacement (sAVR) vs. before sAVR (baseline) was evaluated on median peak workload (watts) (p=<0.001). Surgical aortic valve replacement improved physical work capacity at 1 year, increasing median peak workload from 133 to 144 watts (p<0.001) and ventilatory threshold.
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