[Preoperative assessment of the functional capacity of patients with a mitral defect]

The functional capacity was tested in 83 patients with mitral heart defect by step-like loading of bicycle ergometric test, making use of the indices of physical capacity for work. A complex of clinical, non-invasive and invasive investigation methods was used for the hemodynamic evaluation of the patients. A comparison was performed of the threshold power of loading with the pressure in the cardiac cavities, pulmonary artery and pulmonary capillaries, the degree of valvular stenosis, degree and duration of cardiac insufficiency, cardiac rhythm. The indices of the physical capacity for work and the pressures in the cardiac cavities were juxtaposed in the patients undergone operations and patients with postponed operations. The patients with mitral defect were established to have considerably lower indices of physical capacity for work than the healthy non-trained subjects of the same age. The correlation of threshold power of loading with the pressures in right cardiac catheterization was low. The correlation with the mean pressure in pulmonary capillaries was moderate only in the patients with mitral stenosis but--considerable (with the degree of valvular stenosis in mitral stenosis, degree of cardiac insufficiency in both patient groups and with the functional class according to NIKA)--in combined mitral defect. The patients with postponed operations had better indices of physical capacity for work and were with lower pressures, determined by right cardiac catheterization.