Treadmill test in patients with rheumatic mitral regurgitation

Treadmill tests were performed in 48 patients with rheumatic mitral regurgitation ranging in age from 9 to 18 years, consisted of 17 boys and 31 girls. The method used was Bruce protocol. Patients with heart failure or other valvular defects were excluded from this study. Thirty-eight (79.2%) patients, 15 boys and 23 girls, could reach stage 4 or more. Shorter endurance time was associated with increasing age and larger body surface area, both in boys and girls. In the group of patients with cardiomegaly in their x-ray photos, 83.3% of the boys and 70.0% of the girls could reach stage 4 or more in, while in those without cardiomegaly 100% of the boys and 76.1% of the girls could achieve stage 4 or more. Patients with LVH on their ECGs could reach stage 4 or more in 87.5% of the boys and 85.7% of the girls, while patients without LVH could reach stage 4 or more in 88.8% of the boys and 70.0% of the girls. We conclude that: (1) treadmill test is quite safe for children with mild and moderate rheumatic mitral regurgitation; (2) older age and larger body surface area are associated with lower endurance, (3) cardiomegaly on chest X-ray can be used as a guide for exercise restriction in that group, but this is not true with ECG-LVH.