Document Detail


Argument for a Doppler echocardiography during exercise in assessing asymptomatic patients with severe aortic stenosis.
MedLine Citation:
PMID:  18492656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Exercise stress testing (EST) is recommended by guidelines to risk-stratify patients with asymptomatic valvular aortic stenosis (AS), though the role of quantitative exercise-Doppler echocardiography has rarely been studied. This prospective study sought to correlate standard EST results with the haemodynamic measurements made during exercise by Doppler echocardiography. METHODS AND RESULTS: We performed rest and semi-supine exercise Doppler echocardiography in 44 consecutive patients (mean age=68+/-12 years) with aortic valve areas<or=0.6 cm2/m2. The effective aortic valve area (EOA), cardiac output (CO), maximal transvalvular velocity, and pulmonary pressure were monitored over the test. No serious adverse event was observed. EST was positive in 26 (Group 1) and negative in 18 (Group 2) patients. Baseline echocardiographic measurements were similar (EOA 0.77+/-0.15 vs. 0.78+/-0.14 cm2; CO 5.5+/-1.6 vs. 5.9+/-2 L/min) in both groups. Exercise-induced changes in CO (+2.9+/-2 vs. +4.3+/-1.8 L/min, P=0.04) and EOA (-0.04+/-0.18 vs. +0.15+/-0.24 cm2, P=0.015) were significantly greater in Group 2. A correlation between changes in EOA and changes in CO during exercise was observed, but significantly higher in Group 2 (P=0.04). CONCLUSION: In the presence of severe asymptomatic AS, exercise Doppler echocardiography, assessing the mechanisms behind a positive EST, appears very promising but further studies with prognosis assessment remain necessary.
Authors:
Guillaume Leurent; Erwan Donal; Christian de Place; Céline Chabanne; Renaud Gervais; Claire Fougerou; Alain le Helloco; Jean-Claude Daubert; Philippe Mabo; Marcel Laurent
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-05-20
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  10     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-09     Completed Date:  2009-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  69-73     Citation Subset:  IM    
Affiliation:
Département de Cardiologie et Maladies Vasculaires, Centre Cardio-Pneumologique, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033 Rennes Cedex, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve Stenosis / diagnosis,  ultrasonography*
Cardiac Output
Echocardiography / methods
Echocardiography, Doppler / methods*
Echocardiography, Stress / methods*
Female
Heart Rate
Hemodynamics / physiology*
Humans
Male
Middle Aged
Probability
Prospective Studies
Reference Values
Regression Analysis
Reproducibility of Results
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Stroke Volume

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