{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:01:57Z","timestamp":1781730117319,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T00:00:00Z","timestamp":1233619200000},"content-version":"vor","delay-in-days":3321,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2000,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background<\/jats:italic>: Hemodynamic improvement is a common finding following valve replacement. However, despite a normally functioning prosthesis and normal left ventricular ejection fraction, some patients may show an abnormal hemodynamic response to exercise.<\/jats:p><jats:p><jats:italic>Methods<\/jats:italic>: In a combined catheter\/Doppler study, rest and exercise hemodynamics were evaluated in 23 patients following aortic (n = 12) (Group 1) or mitral valve (n = 11) (Group 2) replacement and compared with preoperative findings. Patient selection was based on absence of coronary artery disease and left ventricular failure as shown by preoperative angiography. Cardiac output, pulmonary artery pressure, pulmonary capillary pressure, and pulmonary resistance were measured by right heart catheterization, whereas the gradient across the valve prosthesis was determined by Doppler echocardiography. Postoperative evaluation was done at rest and during exercise. The mean follow\u2010up was 8.2 \u00b1 2.2 years in Group 1 and 4.2 \u00b1 1 years in Group 2.<\/jats:p><jats:p><jats:italic>Results<\/jats:italic>: With exercise, there was a significant rise in cardiac output in both groups. In Group 1, mean pulmonary pressure\/capillary pressure decreased from 24 \u00b1 9\/18 \u00b1 9 mmHg preoperatively to 18 \u00b1 2\/12 \u00b1 4 mmHg postoperatively (p &lt; 0.05), and increased to 43 \u00b1 12\/30 \u00b1 8 mmHg with exercise (p &lt; 0.05). The corresponding values for Group 2 were 36 \u00b1 12\/24 \u00b1 6 mmHg preoperatively, 24 \u00b1 7\/17 \u00b1 6 mmHg postoperatively (p &lt; 0.05), and 51 \u00b1 2\/38 \u00b1 4 mmHg with exercise (p &lt; 0.05). Pulmonary vascular resistance was 109 \u00b1 56 dyne\u00b7s\u00b7cm<jats:sup>\u20105<\/jats:sup> preoperatively, 70 \u00b1 39 dyne\u00b7s\u00b7cm<jats:sup>\u20105<\/jats:sup> postoperatively (p &lt; 0.05), and 70 \u00b1 36 dyne\u00b7s\u00b7cm<jats:sup>\u20105<\/jats:sup> with exercise in Group 1. The corresponding values for Group 2 were 241 \u00b1 155 dyne\u00b7s\u00b7cm<jats:sup>\u20105<\/jats:sup>, 116 \u00b1 39 dyne\u00b7s\u00b7cm<jats:sup>\u20105<\/jats:sup> (p &lt; 0.05), and 104 \u00b1 47 dyne\u00b7s\u00b7cm<jats:sup>\u20105<\/jats:sup>. There was a significant increase in the gradients across the valve prosthesis in both groups, showing a significant correlation between the gradient at rest and exercise. No correlation was found between valve prosthesis gradient and pulmonary pressures.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: Exercise\u2010induced pulmonary hypertension and abnormal left ventricular filling pressures seem to be a frequent finding following aortic or mitral valve replacement. Both hemodynamic abnormalities seem not to be determined by obstruction to flow across the valve prosthesis and may be concealed, showing nearly normal values at rest but a pathologic response to physical stress.<\/jats:p>","DOI":"10.1002\/clc.4960230107","type":"journal-article","created":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T05:35:51Z","timestamp":1233725751000},"page":"32-38","source":"Crossref","is-referenced-by-count":10,"title":["Rest and exercise hemodynamics before and after valve replacement\u2010A combined doppler\/catheter study"],"prefix":"10.1002","volume":"23","author":[{"given":"G.","family":"Inselmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Jahns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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