[Stages of compensation of circulation in acquired aortic valve disease according to data of physical working capacity].

We examined 194 men (mean age 40 +/- 1.4 years) with acquired aortic valve disease. Basing on the data of estimation of physical working capacity and reserve of cardiorespiratory system we assessed staging of development of compensatory mechanisms of circulation in patients with acquired aortic stenosis and aortic insufficiency. According to working capacity all patients were divided into 4 groups with different hemodynamic response of the organism to physical work. Staged development of mechanisms of compensation of the circulation was found to be related to pronounced left ventricular remodeling: concentric myocardial hypertrophy developed in aortic stenosis while aortic insufficiency was associated with eccentric hypertrophy of the myocardium. These differences in geometry were observed already at stage II. Parameters of systemic hemodynamics and energy expenditures of the heart during exercise practically did not differ between aortic stenosis and insufficiency of aortic valve and were characterized by progressive lowering of efficacy of circulation from stage II to stage IV despite pronounced tension of myocardial reserve. As a result significant lowering of tolerance to physical effort took place in patients of the given group.