Kraus F, Rudolph W
Herz. 1984 Aug;9(4):187-99.
To compare the symptoms with the objectively-determined exercise capacity, the symptoms as well as the exercise capacity with the exercise hemodynamics and the symptoms, exercise capacity and exercise hemodynamics with the severity of the valvular lesion, in 154 patients with aortic regurgitation, mitral regurgitation, aortic stenosis or mitral stenosis, the symptoms were classified according to the New York Heart Association and the exercise capacity was determined by means of bicycle ergometry with simultaneous measurement of heart rate, blood pressure, pulmonary artery pressure, cardiac output and the left ventricular ejection fraction. Among the parameters studied, no relationships could be established; to a certain degree, the exercise hemodynamics correlated with the severity of the valvular lesion in that a markedly pathologic response was associated with the presence of a high-grade valvular lesion. Since the symptoms were not indicative of the exercise capacity, nor the symptoms or the exercise capacity of either the exercise hemodynamics, the exercise ejection fraction or the severity of the valvular lesion, the symptoms and the exercise capacity should be evaluated on the basis of the exercise hemodynamics before they are taken into consideration for meaningful decision-making processes such as establishment of the indication for surgery.
为了比较症状与客观测定的运动能力、症状与运动血流动力学、症状、运动能力和运动血流动力学与瓣膜病变严重程度之间的关系，对154例主动脉瓣反流、二尖瓣反流、主动脉瓣狭窄或二尖瓣狭窄患者，根据纽约心脏协会对症状进行分类，通过自行车测力计同时测量心率、血压、肺动脉压、心输出量和左心室射血分数来测定运动能力。在所研究的参数之间，未能建立联系；在一定程度上，运动血流动力学与瓣膜病变严重程度相关，即明显的病理反应与高级别瓣膜病变的存在有关。由于症状不能指示运动能力，症状或运动能力也不能指示运动血流动力学、运动射血分数或瓣膜病变的严重程度，因此在考虑诸如确定手术指征等有意义的决策过程之前，应基于运动血流动力学对症状和运动能力进行评估。
