【論文摘要】Predictors of Exercise Capacity Recovery Immediately After Mitral Valve Surgery

【論文摘要】二尖瓣瓣膜術後運動能力恢復的預測因子

陳柏言(Bo-Yan Chen) ； 林郁珊(Yu-Shan Lin) ； 蔡蕙羽(Hui-Yu Tsai) ； 郭俐纓(Li-Ying Kuo) ； 黃心怡(Hsin-Yi Huang)

《物理治療》 44卷4期 (2019/12) Pp. 293-294

https://doi.org/10.6215/FJPT.201912.P09

摘要

Background and Purpose: The exercise capacity after surgery was important issue in patients with mitral regurgitation (MR). The goal of our study is to analyze the exercise capacity of post-mitral valve surgery patients and determine the specific predictors that would affect recovery. Methods: A total of 302 patients with mitral regurgitation who had undergone mitral surgery in the Heart Center in Taiwan from August 1, 2013 to December 31, 2015 were included in the study. Data related to specific predictors of operative outcome were collected including demographic data, intra-operative factors, exercise tolerance, heart echo data, concurrent cardiovascular disease history, comorbidities, lifestyle risk factors, and surgery types. Postoperative exercise capacity presented as peak oxygen consumption (VO_2; mL of O_2/kg/min) by exercise tests 3 weeks after surgery. Subjects were separated into two groups: a preserved recovery (peak VO_2 ≥ 65% of predicted VO_(2max)) group and poor recovery group (peak VO_2 ＜ 65% of predicted VO_(2max)). Preliminary univariate analysis was performed to test for the possible relationship between predictive variables and exercise capacity. An analysis of all items shown to be significantly different between two groups was then subjected to multivariate logistic regression analysis. The p values less than 0.05 were considered significant. Results: Female gender (OR = 2.65, 95% CI = 1.58-4.47), obesity (OR = 0.26, 95% CI = 0.10-0.64), sedentary lifestyle (OR = 0.47, 95% CI = 0.28-0.79), and a high pre-operative New York Heart Association (NYHA) Functional Classification level (OR = 0.52, 95% CI = 0.31-0.87) were significant predictors of exercise capacity. Conclusion: Our study found that female gender, obesity, sedentary lifestyle, and low pre-op NYHA Functional Classification level were relatively strong predictors of exercise capacity. Clinical Relevance: Exercise intolerance is a major issue after the treatment of cardiac disease, especially in valvular heart disease. Patients with MR tend to be relatively young and may develop more exercise limitations when comparing with the same age group of patients with other diseases. Professionals should consider the possible presence and effects of lower exercise capacity in these patients after surgery during preoperative evaluation. Without complicated clinical procedures, physicians and medical teams could screen the exercise capacity of mitral valve surgery patients easily, and, if needed, they could prepare a suitable post-surgery plan, or make consultation as early as possible.