Huhmann W
Z Kardiol. 1977 Sep;66(9):491-7.
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.
体育锻炼会增加二尖瓣置换患者瓣膜处的血流量和心率。对26例患者（16例使用SW碟瓣，10例使用LK瓣）的这些参数的影响进行了研究。研究在静息状态、以1瓦/千克体重进行运动期间以及在以120、150和180次/分钟进行心室起搏期间进行。记录了以下参数：左右心压力、压力阶差（ΔP）、心输出量（CO、CI）、肺动脉血氧饱和度（SO2PA）、血流量（F）、流速（Q）以及ΔP/SV比值。所有瓣膜机械性能可靠。LK瓣中碟片的平均开口角度为62度。未出现心肌功能障碍。在所有操作过程中右心压力均升高。静息时ΔP为7.5 mmHg，运动时为20.9 mmHg，起搏时为12.3 mmHg。ΔP随流速和心率增加而增加。ΔP/SV在运动和起搏时不成比例地升高。由于ΔP随流量、流速和心率增加，二尖瓣置换术后应避免体力活动。讨论了替代治疗方案。
