What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: isolated mitral stenosis (n=70). Intervention: Sinus rhythm vs. Atrial fibrillation. Primary outcome: Peak oxygen uptake (p=< 0.05).

What does this research mean for the field?

In patients with mitral stenosis, peak oxygen uptake during exercise is higher in those with sinus rhythm compared to atrial fibrillation, and exercise tolerance does not correlate with resting mitral valve area or gradient. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to explore the determinants of peak oxygen uptake during maximal exercise in patients with mitral stenosis, comparing those in sinus rhythm and atrial fibrillation.

June 26, 2026European Heart Journal

Peak oxygen uptake during exercise in mitral stenosis with sinus rhythm or atrial fibrillation: lack of correlation with valve area

Q: What are the key findings of this study?

Peak oxygen uptake was higher in mitral stenosis patients with sinus rhythm compared to atrial fibrillation (21.3 vs 18.1 ml/min/kg, P<0.05), and did not correlate with mitral valve area.

Q: What does this research mean for the field?

In patients with mitral stenosis, peak oxygen uptake during exercise is higher in those with sinus rhythm compared to atrial fibrillation, and exercise tolerance does not correlate with resting mitral valve area or gradient. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

This research aims to explore the determinants of peak oxygen uptake during maximal exercise in patients with mitral stenosis, comparing those in sinus rhythm and atrial fibrillation.

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Why the study?

Determinants of peak oxygen uptake during maximal upright exercise in mitral stenosis are poorly characterized and may differ between sinus rhythm and atrial fibrillation.

Does peak oxygen uptake during exercise correlate with resting valve area or gradient in patients with mitral stenosis?

Comparison

Sinus rhythm vs atrial fibrillation

Key result

Peak oxygen uptake was higher in mitral stenosis patients with sinus rhythm compared to atrial fibrillation (21.3 vs 18.1 ml/min/kg, P<0.05), and did not correlate with mitral valve area.

Authors

ACAlain Cohen‐Solal JAJ.-F. Aupetit MDM Dahan

Discussion

Member takes

Overview

Valve area does not predict peak VO2 in mitral stenosis; leaves open the determinants of exercise capacity for prospective study.

Key Points

This research aims to explore the determinants of peak oxygen uptake during maximal exercise in patients with mitral stenosis, comparing those in sinus rhythm and atrial fibrillation.
Seventy patients with isolated mitral stenosis underwent Doppler-echocardiography and bicycle exercise testing.
Patients were categorized into two groups: 42 in sinus rhythm and 28 in atrial fibrillation.
Peak oxygen uptake was measured using respiratory gas analysis during the exercise.
Peak oxygen uptake was 21.3 ml.min-1.kg-1 in sinus rhythm and 18.1 ml.min-1.kg-1 in atrial fibrillation (P < 0.05).
No significant correlation was found between valve area or gradient and measures of exercise tolerance in either group.
In sinus rhythm, indexed peak oxygen uptake was linearly related to delta heart rate (r = 0.43), but not in atrial fibrillation.

Study Design

Type

Cross-Sectional (n=70)

Structured PICO

Does peak oxygen uptake during exercise correlate with resting valve area or gradient in patients with mitral stenosis?

Population

70 patients with isolated mitral stenosis (42 in sinus rhythm and 28 in atrial fibrillation) who underwent Doppler-echocardiography and bicycle exercise with respiratory gas analysis.

Outcome

Peak oxygen uptake and its correlation with mitral valve area or gradientsurrogate

Main Result

Absolute Event Rate: 21.3% vs 18.1%

p-value: p=< 0.05

In patients with mitral stenosis, maximal upright exercise tolerance does not correlate with resting mitral valve area or gradient, suggesting peripheral adaptation and chronotropic reserve are the primary compensatory mechanisms.

Cite This Study

Cohen‐Solal et al. (1994) conducted a cross-sectional in isolated mitral stenosis (n=70). Sinus rhythm vs. Atrial fibrillation was evaluated on Peak oxygen uptake (p=< 0.05). Peak oxygen uptake was higher in mitral stenosis patients with sinus rhythm compared to atrial fibrillation (21.3 vs 18.1 ml/min/kg, P<0.05), and did not correlate with mitral valve area.

synapsesocial.com/papers/6a3e44147e90e355b84999ae https://doi.org/10.1093/oxfordjournals.eurheartj.a060377

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June 26, 2026European Heart Journal

Peak oxygen uptake during exercise in mitral stenosis with sinus rhythm or atrial fibrillation: lack of correlation with valve area

View Full Paper

Ask AI

Bookmark

Why the study?

Determinants of peak oxygen uptake during maximal upright exercise in mitral stenosis are poorly characterized and may differ between sinus rhythm and atrial fibrillation.

Does peak oxygen uptake during exercise correlate with resting valve area or gradient in patients with mitral stenosis?

Comparison

Sinus rhythm vs atrial fibrillation

Key result

Peak oxygen uptake was higher in mitral stenosis patients with sinus rhythm compared to atrial fibrillation (21.3 vs 18.1 ml/min/kg, P<0.05), and did not correlate with mitral valve area.

Authors

ACAlain Cohen‐Solal JAJ.-F. Aupetit MDM Dahan

Discussion

Member takes

Overview

Valve area does not predict peak VO2 in mitral stenosis; leaves open the determinants of exercise capacity for prospective study.

Key Points

This research aims to explore the determinants of peak oxygen uptake during maximal exercise in patients with mitral stenosis, comparing those in sinus rhythm and atrial fibrillation.
Seventy patients with isolated mitral stenosis underwent Doppler-echocardiography and bicycle exercise testing.
Patients were categorized into two groups: 42 in sinus rhythm and 28 in atrial fibrillation.
Peak oxygen uptake was measured using respiratory gas analysis during the exercise.
Peak oxygen uptake was 21.3 ml.min-1.kg-1 in sinus rhythm and 18.1 ml.min-1.kg-1 in atrial fibrillation (P < 0.05).
No significant correlation was found between valve area or gradient and measures of exercise tolerance in either group.
In sinus rhythm, indexed peak oxygen uptake was linearly related to delta heart rate (r = 0.43), but not in atrial fibrillation.

Study Design

Type

Cross-Sectional (n=70)

Structured PICO

Does peak oxygen uptake during exercise correlate with resting valve area or gradient in patients with mitral stenosis?

Population

70 patients with isolated mitral stenosis (42 in sinus rhythm and 28 in atrial fibrillation) who underwent Doppler-echocardiography and bicycle exercise with respiratory gas analysis.

Outcome

Peak oxygen uptake and its correlation with mitral valve area or gradientsurrogate

Main Result

Absolute Event Rate: 21.3% vs 18.1%

p-value: p=< 0.05

Cite This Study

synapsesocial.com/papers/6a3e44147e90e355b84999ae https://doi.org/10.1093/oxfordjournals.eurheartj.a060377

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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