Landry F, Habel C, Desaulniers D, Dagenais G R, Moisan A, Côté L
Am J Cardiol. 1984 Feb 1;53(4):562-6. doi: 10.1016/0002-9149(84)90031-6.
Improved prosthetic aortic valves have reduced the incidence of complications to a point where it can be hypothesized that functional class I subjects after aortic valve replacement (AVR) should adapt to a vigorous training program without a significant increase of hemolytic activity or clinical signs of prosthesis malfunction. To test this hypothesis, 10 men (mean age 52 years) who had undergone AVR (7 Björk-Shiley and 3 Lillehei-Kaster) were submitted to an 8-week training program on ergometer, 3 times/week, from 60 to 80% of individual maximal heart rate. Ten other men who had undergone AVR but did not participate in the training program were control subjects. The exercise program produced significant improvements in posttraining maximum tolerated ergometer work load (210 kpm, p less than 0.001), in maximum total body oxygen consumption (5 ml/kg X min-1, p less than or equal to 0.01) and in double product at submaximal work load (-5,126, p less than or equal to 0.01). After training, hemoglobin decreased by about 1 g% (p less than or equal to 0.05) and hematocrit, reticulocyte counts and haptoglobin did not change significantly. Serum LDH and serum AST did not increase. Pre- and post-training echocardiograms did not show detectable alterations. Thus, patients with AVR who are in functional class I can adapt to a physical exercise program without significant adverse effects.
改良后的人工主动脉瓣膜已将并发症的发生率降低到这样一个程度，即可以推测，主动脉瓣置换术（AVR）后功能分级为I级的患者应能适应高强度训练计划，而不会显著增加溶血活性或人工瓣膜功能障碍的临床体征。为了验证这一假设，对10名接受过AVR手术的男性（平均年龄52岁，其中7人植入Björk-Shiley瓣膜，3人植入Lillehei-Kaster瓣膜）进行了为期8周的测力计训练计划，每周3次，心率维持在个人最大心率的60%至80%。另外10名接受过AVR手术但未参加训练计划的男性作为对照。训练计划使训练后最大耐受测力计工作量（210 kpm，p<0.001）、最大全身耗氧量（5 ml/kg×min-1，p≤0.01）以及次最大工作量时的双乘积（-5,126，p≤0.01）均有显著改善。训练后，血红蛋白下降约1 g%（p≤0.05），血细胞比容、网织红细胞计数和触珠蛋白无显著变化。血清乳酸脱氢酶（LDH）和血清谷草转氨酶（AST）未升高。训练前后的超声心动图未显示可检测到的改变。因此，功能分级为I级的AVR患者能够适应体育锻炼计划，且无明显不良反应。
