Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Strobl, J.
Effects of submaximal exercise on cardiovascular parameters during recovery from minimal invasive aortic valve replacement interventions
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 60
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Goswami Nandu
- Rössler Andreas
- Altmetrics:
- Abstract:
- Introduction: Aortic stenosis is a chronic, progressive valve disease very common in the elderly population of the western world. If left untreated it leads to reduction of cardiovascular system (CVS) and autonomic function, left heart insufficiency, sudden cardiac arrest, syncope and ultimately premature death. Therefore, these patients sooner or later are in need for aortic valve replacement. New technics, such as the mini sternotomy, have been introduced in the past years and showed supremacy over conventional methods. Usually only hard end-points such morbidity and mortality are considered when evaluating patient outcome after these minimal invasive aortic valve replacement interventions. However functional parameters of CVS and autonomic system function could give useful insight of how recovery in these patients’ manifests. So far cardiopulmonary exercise tests have not been used in early stages of recovery. In the literature there is thus no insight found on how exercise tests effect CVS and autonomic function parameters in these patients after recovering from minimal aortic valve replacement interventions. Aims & Objectives: This study aims to investigate early changes in cardiovascular and autonomic function after aortic valve replacement surgery, by using submaximal cardiopulmonary exercise testing (CPET). Materials & Methods: A sample of 10 aortic stenosis patients was matched to a heathy control group (n=10) and assessed with submaximal CPET at three times (pre-operative, 5 days’ post-operative, 3 weeks post-operative). The assessed CVS parameters: rest HR, peak HR, HR recovery and decrement were compared between these three times by multivariate variance analysis. Pre-operative CVS parameters of the aortic stenosis group were secondly compared to the healthy control group. Post-operative, half the aortic stenosis patients (n=5) received ß-blocker therapy with bisoprolol. Thus, the aortic stenosis group was split up and analyzed separately. Results: Expected difference in CVS parameters between aortic stenosis and healthy control was slightly not significant. Further no significant difference was found for rest HR, peak HR, HR recovery and decrement between pre-operative and post-operative 5 days. 3 weeks’ post-operative a significantly lower peak (p=.002) and rest HR (p=.025) was found in both ß-blockaded and non ß-blockaded aortic stenosis groups. However no significant difference between heart rate decrement in both groups was found. Conclusions: Results indicate, that no improvement of CVS and autonomic function within the first 5 days of recovery takes place. Cardiac function improves within 3 weeks’ post-operative (lower resting and peak heart rate). Autonomic function improvement however, might take longer than 3 weeks (no acceleration of HR recovery and decrement).