Does Hi impact training affect a patient with Mechanical aortic valve?

[Guest]

I am interested to know if there is someone in the group who practice hi intensity exercise like cycling, Running, soccer, weight lifting, cross fit, etc. where the heart rate is around 75 to a 90% of their MAX HR.
I practice MTB and recently got back to local competitions. Last weekend I did fine in a local race. I got a 6[SUP]th[/SUP] place in the race, but my heart rate got a little higher than I would expected.
It was a 36KM (22.5 Mile) race , flat rocky and dusty section, no crazy up hills, I did 1 hour an 19 minutes, my average HR was 159 and the max HR was 179. The 179 HR was only at the end of the race and for less than 45 seconds. I had my mechanical Aortic valve replaced on 05/30/15 almost 9 months ago.
After the race I felt fine, no complications, no drama at all. Except I was super happy because I did better than previous years.

What sport do you practice? how Hi do you keep your HR? what is your Max HR? How do you feel after a heavy training and your HR is higher than normal? What does your cardiology thinks about it?
Of course I will discuss this with my cardiologist in the next appointment and I will share his thoughts.

Please excuse my bad orthography, as you just noticed, English is not my first language.
Thank you and I hope you are doing great.
Regards
Hector V.

 

[QuincyRunner]

Hi Hector - I have a mechanical mitral valve and compete frequently in 5K races. I monitor my heart rate constantly, more out of curiosity than anything else, because I don't follow my cardiologist's advice to keep my heart rate below 80 percent of max. Since I am 57 years old my maximum HR is supposedly 163 (using the common formula of 220 minus my age) but toward the end of my 5K races my HR hits the low 170's. Obviously my max cannot be 163 but I have no doubt that I am hitting my max in these races based on the fact that I am pushing myself to the limit. So far my valve has not detached and my heart has not exploded. If I followed the common medical wisdom of keeping my HR below 80 percent of max (which would be in the 140's) I would not even be able to jog during my normal training days because even then I get to around 150. Giving up running is unacceptable so basically I just ignore those manufactured restrictions. I have run about 75 races since my MVR over 4 years ago. So far so good.

 

[SumoRunner]

Not so far, but I've only had this valve for 25 years. I have run to max HR so many times I can't count. Interval training, racing from 800 meters to half-marathon, over 350 races and 25,000 miles since AVR.

 

[Bean Counter]

I had my aortic valve replaced in 2010 with a tissue valve and have done my fair share of hi-intensity workouts over the years without any issues. I never knew what my max HR was before surgery as I always did a "poor mans" alternative to a lactate test and determined my proper HR training zones from there. I have done both tempo runs (which typically will be 80-98% of Max HR) and have done mile repeats on the track. For mile repeats, I let my goal pace dictate my effort rather than HR. If I had to guess, I would suspect that my mile repeats wold put me around 93-95% MHR. For everyday easy runs (a majority of my weekly mileage, I am probably in the 70-75% MHR range).

This is the test I used to determine my training zones:

http://www.trainingbible.com/joesblog/2009/11/quick-guide-to-setting-zones.html

Joe Friel is a well respected triathlon coach that has been around for a long time, so I put a lot of trust in his advice.

 

[Earthsciencerocks]

Earlier this week I went in to have my yearly echocardiogram. My heart was feeling like something was "off" a bit. Found out my aortic Medtronic Freestyle (porcine tissue valve) had a leaflet break and stop functioning. My valve was 9 years old. I am a 3-4 day a week weight lifter in the gym, and 4-5 day a week cardio of 3-5 miles either outside or on the treadmill pending on weather. I am 48 years old, 6' and around 240lbs. Bad news is my valve broke, good news is I'm going in for a new one April 25th. I was coached into changing my routine a bit after surgery. Looks like I'm gonna have to do more work with diet and less heavy lifting. Oh well, I'm capable of this, and look forward to many more years of staying strong and active! Good luck fellow valvers!

 

[Earthsciencerocks]

Earlier this week I went in to have my yearly echocardiogram. My heart was feeling like something was "off" a bit. Found out my aortic Medtronic Freestyle (porcine tissue valve) had a leaflet break and stop functioning. My valve was 9 years old. I am a 3-4 day a week weight lifter in the gym, and 4-5 day a week cardio of 3-5 miles either outside or on the treadmill pending on weather. I am 48 years old, 6' and around 240lbs. Bad news is my valve broke, good news is I'm going in for a new one April 25th. I was coached into changing my routine a bit after surgery. Looks like I'm gonna have to do more work with diet and less heavy lifting. Oh well, I'm capable of this, and look forward to many more years of staying strong and active! Good luck fellow valvers!

 

[JulienDu]

Earlier this week I went in to have my yearly echocardiogram. My heart was feeling like something was "off" a bit. Found out my aortic Medtronic Freestyle (porcine tissue valve) had a leaflet break and stop functioning. My valve was 9 years old. I am a 3-4 day a week weight lifter in the gym, and 4-5 day a week cardio of 3-5 miles either outside or on the treadmill pending on weather. I am 48 years old, 6' and around 240lbs. Bad news is my valve broke, good news is I'm going in for a new one April 25th. I was coached into changing my routine a bit after surgery. Looks like I'm gonna have to do more work with diet and less heavy lifting. Oh well, I'm capable of this, and look forward to many more years of staying strong and active! Good luck fellow valvers!

The guy is asking about Mech valve....So lesson of the day, if you want to do a lot of heavy lifting without restrictions, do not chose a tissue valve. I wonder how much heavy lifting a pig do in his life ?

I am only 2 months post op and I have already reach 99percent MAX HR in activities. Mech valve as it was said many times won't be an issue for heavy activities.

With a Mech valve you can even push harder than tissue without worrying about damaging your valve. ( follow your cardio advices of course )

 

[Earthsciencerocks]

Earlier this week I went in to have my yearly echocardiogram. My heart was feeling like something was "off" a bit. Found out my aortic Medtronic Freestyle (porcine tissue valve) had a leaflet break and stop functioning. My valve was 9 years old. I am a 3-4 day a week weight lifter in the gym, and 4-5 day a week cardio of 3-5 miles either outside or on the treadmill pending on weather. I am 48 years old, 6' and around 240lbs. Bad news is my valve broke, good news is I'm going in for a new one April 25th. I was coached into changing my routine a bit after surgery. Looks like I'm gonna have to do more work with diet and less heavy lifting. Oh well, I'm capable of this, and look forward to many more years of staying strong and active! Good luck fellow valvers!

 

[pellicle]

Hi Hector

I am interested to know if there is someone in the group who practice hi intensity exercise like cycling, Running, soccer, weight lifting, cross fit, etc. where the heart rate is around 75 to a 90% of their MAX HR.

I'm not sure I can answer that question well because I don't really track my VO, but I can say that I "play" at cross country skiing. I'm not an athlete (certainly not by Finnish standards) but I go out 3 to 4 days per week on the lake in Finland when its the season (and usually a bit after its ended).

I've found that in my first season back after my mechanical AVR (I'd previously had a human valve called a homograft) in from age 28 to 48) with a mechanical that I was at least as fit and certainly did better times and had better endurance than before on the snow.

I find that my personal MAX HR that I can sustain without burnout is about 150 ... I can do spurts of 177 or 180 for a while (minutes) but then I'm knackered and need to wait a few minutes to recover. If I was cycling (which I also do a bit, again not competitively) then if I've timed it to peak the hill at that then I can "catch my breath" on the down side of the hill.

Perhaps this article will help you to understand another aspect of the "limitations" imposed by a Mechanical valve

http://www.newsweek.com/my-turn-clim...ic-heart-99749

[FONT=playfair_displayregular]When I was 23 I was diagnosed with aortic valve [/FONT][FONT=playfair_displaybold]disease[/FONT][FONT=playfair_displayregular], which meant that one of the four valves controlling the flow of blood to my heart was failing to function properly. During the 1990s my condition began to worsen, and mountain climbing became more difficult. By the late 1990s even climbing stairs was exhausting. So in 1997, at age 46, I underwent heart valve replacement[/FONT][FONT=playfair_displaybold]surgery[/FONT][FONT=playfair_displayregular] and received a mechanical heart valve. Five weeks later I was back climbing mountains with a new determination. In my previous attempts to reach the peak of Everest, it wasn't my mechanical heart valve that held me back: twice it was the altitude and illness, and twice the weather conditions forced me to give up on my quest for the peak. Each time, though, I was able to take something important with me from my trip.[/FONT]

myself I now expect that my new valve will last the rest of my life (barring unusual situations) wheras on my homograft noone could ever answer "how long will it last" ... it was always "we don't know"

Best Wishes

 

[pellicle]

Hi

.... Found out my aortic Medtronic Freestyle (porcine tissue valve) had a leaflet break and stop functioning.

that's a bummer ... I had assumed that your valve was calcifying in your earlier post. Such things as valve leaflets breaking is uncommon. Did it "break" ... can you clarify if that's the case or if it was "stenosis" caused by calcification (which is normal end of life on tissue valves)?

Best Wishes

 

[Heart2.0]

I have a tissue valve AVR. I am still working up to gradual fitness gains. You all are the only people for me to talk to. Being a non professional athlete and female age 55 , I have been completely
dismissed as deserving of extra targeted help. I know for a fact if I was a male runner or bicyclist , my ACH dr would have had different advice . Hearing I am the first person at Kaiser Los Angeles to request an exercise physiologist, lets me know my quality of life issues will never be addressed. I went to Scrips Preybs cardio rehab for
a consult and then saw another older more experienced Cardiologist in Kaiser San Diego. With their concurring advice, now I am really trying to move my heart rate up
to 140’s and closer to 150 in interval training. I lift weights and swim laps also. But the feed back I get at KP absolutely disregards the premium I place on
a physical life style and my actual grief at not being able to do better and feel better. It is bizarre. So, I pay out of pocket to go weekly to a private hospital gym
run by an exercise physiologist. I request the Zio patch monitor every 6 months and I'll have another Eco in 3 more. Because I am worried still about damaging my valve!
But I realize the initial suggested H rate max of 135 doesn't allow for actual dancing jogging or race walking!
It is often very scary though.
I don't claim to be in an athlete class and yet I am most certainly not casual. There are simply
no studies I know of to read and in lieu of that , an older cardiologist's practical experience is my only support. But will I wreck my heart? It is very much a man's world
In the medical studies field and most certainly at Kaiser. I was most misled by the blithe commentary on how I would be better than before. Yea, no. I used to
run long distance. Now I can't even sustain race walking on the treadmill for more than 90seconds before gasping. But that's a 200% improvement from last year.
At that rate maybe 60 more years? / so I guess I am not fitting the pattern of too sick to move /not well enough to run , as seems to be the consensus when I interviewed
many different cardio rehab level 3 nurses. ( btw nicest people ever! I just made random calls to units to get anecdotal feedback)
So keep collecting information
talk to people with experience, read about training, consider writing to a university with a comprehensive cardio rehabilitation program for patients with labor intensive jobs.
Just keep pushing for information and listen to you body. I find the non invasive tests very reassuring as I am flying blind so to speak creating my own exercise regime.
Good luck to you! Our quality of life absolutely includes physical exertion even if others cannot appreciate that view.

 

[RossN]

Pretty helpful stuff this. I'm 4&1/2 months post avr (mech) & have built up to 3km this past weekend following a lot of walking pre & post surgery. Everyone worries for me about doing this sort of exercise so soon. Any advice? P.S. Love the story from Sumo!