Abstract
Aim: Peak oxygen uptake (peakVO2) is one of the strongest predictors of survival in patients with valvular heart disease. The purpose of this study was to determine whether endurance training improves peakVO2 and endurance capacity in patients with moderate-severe aortic and mitral valve disease.Methods: 30 patients with moderate-severe valvular heart disease were randomly assigned to 12 weeks of endurance training (TG) (n = 16) or standard care (SC) (n = 14). PeakVO2 and maximum working capacity (Wattmax) were assessed by cardiopulmonary exercise testing, as well as submaximal endurance test at 80% of peakVO2 at baseline and after 12 weeks.Results: There was a significant improvement in peakVO2 from 27.2 ± 5.9 ml/kg to 30.4 ± 6.3 ml/kg (P < 0.001) in TG compared to the SC (peakVO2 from 24.6 ± 4.4 to 24.7 ± 3.8) and in the Wattmax from 151.8 ± 41.0 Watt to 171.2 ± 49.7 Watt in the TG compared to the SC (152.9 ± 35.6 Watt to 149.2 ± 28.4 Watt). The endurance capacity increased significantly from 17.0 ± 9.4 min to 32.8 ± 16.8 min (p = 0.003) in the TG compared to the SC (11.7 ± 6.2 min to 11.2 ± 7.6 min). The heart rate during the endurance test decreased in the TG from 154 ± 14 b/min to 142 ± 20 b/min for the same workload. No changes could be seen in the SC.Conclusion: Endurance training in patients with moderate to severe valvular heart disease increased significantly the peakVO2 as well as the endurance capacity.
Highlights
The clinical value of cardiopulmonary exercise test (CPET) offers diagnostic and prognostic information in patients with cardiovascular disease, especially concerning the peak oxygen uptake [1,2,3,4]
There was a significant improvement in peakVO2 from 27.2 ± 5.9 ml/kg to 30.4 ± 6.3 ml/kg (P < 0.001) in TG compared to the standard care (SC) and in the Wattmax from 151.8 ± 41.0 Watt to 171.2 ± 49.7 Watt in the TG compared to the SC (152.9 ± 35.6 Watt to 149.2 ± 28.4 Watt)
The endurance capacity increased significantly from 17.0 ± 9.4 min to 32.8 ± 16.8 min (p = 0.003) in the TG compared to the SC (11.7 ± 6.2 min to 11.2 ± 7.6 min)
Summary
The clinical value of cardiopulmonary exercise test (CPET) offers diagnostic and prognostic information in patients with cardiovascular disease, especially concerning the peak oxygen uptake (peakVO2) [1,2,3,4]. PeakVO2 measured during CPET was found to objectively assess functional capacity in patients with valve disease [6,7,8]. Endurance training improves exercise capacity and quality of life in patients after myocardial infarction, coronary artery bypass graft surgery, and with heart failure [9,10,11] as well as after heart valve surgery [12,13,14]. The aim of this study was to investigate the effects of a 12 weeks supervised aerobic endurance training in patients with moderate to severe valve disease on the primary outcome peakVO2 and secondary outcomes maximum working capacity and endurance capacity While exercise training is recommended in patients with moderate valve disease [15,16,17,18], the implication of training in patients with severe disease remains unclear.
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