Próteses = Bicicleta


Effective Orifice Area during Exercise in Bileaflet Mechanical Valve Prosthese



Exercise Testing

All participating patients underwent symptom-limited graded bicycle tests in semisupine position on a tilting exercise table. Workload was initiated at 20 W, with increments of 20 W every 3 min. At each stage of exercise, Doppler echocardiography assessing LV stroke volume, peak and mean transprosthetic gradient, EOA, transprosthetic flow rate, and systolic pulmonary artery pressure was performed. In addition, blood pressure, 12-lead electrocardiogram, and ergospirometry (JAEGER, Würzburg, Germany) was measured throughout the exercise test.



In bileaflet mechanical valve prostheses, there is no clinically relevant increase in EOA during dynamic exercise. Transprosthetic gradients during exercise closely adhere to the fundamental pressure-flow relationship. Indexed EOA at rest is a strong predictor of exercise capacity in MVR patients. This should be taken into account in therapeutic decision making and prosthesis selection in young and dynamic patients.


Quando alunos e leitores perguntam por que a bicicleta e não a esteira, esquecem do leque interminável de questões que só o  pedal a pedal da bicicleta permite.





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