The effect of handgrip upon Doppler data in mitral stenosis

The usefulness of physical rehabilitation in patients with valvular heart disease is now well established. But, mainly in mitral stenosis, the isometric exercises are under question, because of the risk of sudden rise in capillary pulmonary pressure. In order to clarify this aspect we have studied the effect of isometric exercise upon Doppler data in mitral stenosis.

in 25 patients with mitral stenosis the Doppler indices of severity-mitral valve area (MVA), pressure half time (PHT), maximal velocity (MxV), mean pressure gradient (MPG)-were determined before and after 3-4 minutes of handgrip performed with a dynamometer at 30% of the maximal voluntary contraction (MVC). There are no significant differences of Doppler parameters before and during handgrip: MVA (1.56 +/- 0.30/1.49 +/- 0.53 cm2), PHT (171 +/- 72/150 +/- 58 ms) MPG (7.07 +/- 2.61/7.21 +/- 1.8 mmHg), MxV (2.186 +/- 0.79/2.276 +/- 0.73 m/s). The results suggest that mild isometric exercise does not alter hemodynamic parameters in mitral stenosis. Consequently isometric exercise can be included in physical programmes of rehabilitation for this category of patients.