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人工瓣膜置换术后运动能力和体力活动与心血管功能的关系(作者译)

[Exercise capacity and physical activity following prosthetic valve replacement in relation to cardiovascular function (author's transl)].

作者信息

Mattern H, Wisskirchen K J, Fricke G, Bernhard A

出版信息

Z Kardiol. 1979 Jan;68(1):36-40.

PMID:419807
Abstract

31 patients (Pt) with Mitral Valve Repacement (MVR), 22 Pt with Aortic VR (AVR) and 10 Pt with Double VR (DVR) are investigated hemodynamically and by ergometry. Normal working capacity (100% WC) has been achieved in 59% of Pt with AVR, in 34% with MVR and in 22% with DVR. Pulmonary artery mean pressure (PAMP) in this group was 19.5 mmHg, in a second group with a WC of 80% PAMP was 22.2 mmHG. 77% OF Pt with AVR are working regularly, in MVR 58% and in DVR 50%. In the average of these Pt, 7 months after VR professional occupation is started again. PAMP and pulmonary vascular resistance (APR) is significantly lower in the working vs. the non working group: PAMP 19.8/23.7 mmHg; APR 115/145 dynes sec cm-5, respectively. In MVR, the transprosthetic pressure gradient at rest was 4.1 (working PPT) and 7.5 mmHg (other); in AVR statistically no significant difference in the gradient could be found. In general, 68% of the working Pt are employed in a preferably sedentary job. The mean duration of daily work was estimated to 6.7 hours. It is concluded that AVR yields more favourable results in terms of regaining normal working activity than MVR. Cardiovascular function and physical capability in Pt with DVR are approximately comparable to MVR.

摘要

对31例接受二尖瓣置换术(MVR)的患者、22例接受主动脉瓣置换术(AVR)的患者和10例接受双瓣置换术(DVR)的患者进行了血流动力学和运动试验研究。59%接受AVR的患者、34%接受MVR的患者和22%接受DVR的患者达到了正常工作能力(100%WC)。该组患者的肺动脉平均压(PAMP)为19.5mmHg,在工作能力为80%WC的第二组中,PAMP为22.2mmHg。77%接受AVR的患者能正常工作,接受MVR的患者中这一比例为58%,接受DVR的患者中为50%。这些患者平均在瓣膜置换术后7个月重新开始职业工作。工作组的PAMP和肺血管阻力(APR)显著低于非工作组:PAMP分别为19.8/23.7mmHg;APR分别为115/145达因秒厘米⁻⁵。在MVR中,静息时人工瓣膜压力阶差为4.1(工作时PPT)和7.5mmHg(其他情况);在AVR中,未发现压力阶差有统计学显著差异。总体而言,68%能工作的患者从事的是久坐性工作。估计每日平均工作时长为6.7小时。得出的结论是,在恢复正常工作活动方面,AVR比MVR产生更有利的结果。DVR患者的心血管功能和身体能力与MVR大致相当。

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