[Physical training of patients after mitral valve replacement (author's transl)]

Physical training increases blood flow across the valve and heart rate in patients with mitral valve replacement. The influence of these parameters were studied in 26 pts. (16 SW-disc valves, 10 LK-valves). The investigations were made at rest, during exercise with 1 Watt/kg BW, and during ventricular pacing at 120, 150, and 180 beats/min. The following parameters were recorded: pressures in the right and left heart, pressure gradients (deltaP), cardiac output (CO, CI), pulmonary artery oxygen saturation (SO2PA), blood flow (F), flow velocity (Q), and the fraction of deltaP/SV. All valves were mechanically reliable. Mean opening of the disc in the LK-valves was 62 degrees. There was no myocardial dysfunction. Pressures in the right heart were elevated during all procedures. deltaP at rest was 7.5 mmHg, 20.9 mmHg during exercise, and 12.3 mmHg during pacing. deltaP increased with increasing flow velocity and heart rate. deltaP/SV rose disproportionately with exercise and pacing. Since deltaP increases with flow volume, flow velocity, and heart rate physical activity after mitral valve replacement should be avoided. Alternative therapeutic concepts are discussed.