Key result
Mitral valve repair is linked to a ~6% decrease in peak oxygen consumption postoperatively.
Why the study?
Little is known about the effect of mitral valve repair surgery on cardiopulmonary exercise test variables in patients with chronic mitral regurgitation.
Does mitral valve repair improve cardiopulmonary exercise testing variables in patients with severe chronic mitral regurgitation?
Cohort (n=47)
Does mitral valve repair improve cardiopulmonary exercise testing variables in patients with severe chronic mitral regurgitation?
Absolute Event Rate: 1609% vs 1719%
p-value: p=0.036
Mitral valve repair in patients with severe chronic mitral regurgitation does not increase peak VO2 but improves oxygen pulse, suggesting enhanced left ventricular systolic performance.
Mitral repair did not raise peak VO2 or OUES in severe MR; leaves open CPET utility for surgical timing in observational cohorts.
BACKGROUND: Mitral valve repair is the surgical procedure of choice for patients with chronic Mitral Regurgitation (MR). The good early and late results allow surgical indication before symptom onset. The cardiopulmonary exercise test (CPET) can objectively assess functional capacity, but little is known about the effect of surgery on their variables. OBJECTIVE: Evaluate the effects of mitral repair on CPET variables in patients with chronic MR. METHODS: A total of 47 patients with severe MR were selected; these patients underwent mitral valve repair and were submitted to CPET ± 30 days before surgery, as well as six to 12 months after the surgery. RESULTS: There was predominance of functional class I or II NYHA in 30 (63.8%) and 34 patients (72.3%), respectively. A significant decrease in oxygen consumption (VO2) was observed after surgery, from 1,719 ± 571 to 1609 ± 428 mL min-1, p = 0.036. There was a decrease in Oxygen Uptake Efficiency Slope (OUES) from 1,857 ± 594 to 1763 ± 514, p = 0.073 and oxygen pulse (O2) increased after surgery, from 11.1 ± 3.2 to 11.9 ± 3, 2 mL.beat-1 (p = 0.003). CONCLUSION: The mitral valve repair did not increase peak VO2 and OUES despite positive cardiac remodeling observed seven months after surgery. However, O2 pulse increased postoperatively, suggesting improved LV systolic performance. The CPET is a useful tool to assist in the medical management of patients with MR.
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Togna et al. (2013) conducted a cohort in Chronic Mitral Regurgitation (n=47). Mitral valve repair vs. Preoperative baseline was evaluated on Oxygen consumption (VO2) (p=0.036). Mitral valve repair in patients with severe chronic mitral regurgitation significantly decreased peak oxygen consumption from 1,719 to 1,609 mL/min (p=0.036) at 6 to 12 months postoperatively.
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