Document Detail


Determinants of exercise-induced increase of mitral regurgitation in patients with acute coronary syndromes.
MedLine Citation:
PMID:  20345442     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mechanisms behind exercise-induced increase of mitral regurgitation (MR) in patients with chronic ischemic heart disease have been described earlier. We describe the determinants of exercise-induced changes in MR in patients with non-ST-elevation acute coronary syndrome (NSTACS). METHODS: Forty-five consecutive patients (mean + or - SD age 64 + or - 10 years, 37 men) with NSTACS underwent exercise echocardiography on a supine bicycle the day before angiography. The exercise was started with a load of 10 W with increments of 10 W every minute until symptoms developed or a max load of 100 W. Effective regurgitation orifice (ERO) was measured at rest and at peak exercise. RESULTS: Twelve patients had more than trace MR at rest with ERO 8 + or - 5 (mean + or - SD), range: 3-18 mm(2). In these patients, ERO increased during exercise to 13 + or - 6 (mean + or - SD), range: 6-23 mm(2) corresponding to an increase of 70% from rest (P = 0.001). Seven other patients developed new MR during exercise with ERO at peak exercise of 8 + or - 4 mm(2) (mean + or - SD), range: 4-14 mm(2). All these patients had significant increase in wall motion score index (WMSI) of 0.14 + or - 0.18 (mean + or - SD), P = 0.006, while in the 25 patients without MR at rest or during exercise, WMSI remained unchanged, -0.02 + or - 0.08 (mean + or - SD), P = 0.2. CONCLUSION: Exercise-induced increases of MR in patients with NSTACS are related to worsening of regional wall motions. (Echocardiography 2010;27:567-574).
Authors:
Redi Pecini; Sophia Hammer-Hansen; Morten Dalsgaard; Jens Peter Gøtze; Christian Hassager; Lars Køber
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-25
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  27     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  567-74     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark. redpecini@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / physiopathology*,  ultrasonography*
Aged
Chi-Square Distribution
Coronary Angiography
Echocardiography, Stress / methods*
Female
Humans
Linear Models
Male
Middle Aged
Mitral Valve Insufficiency / etiology,  physiopathology*,  radiography,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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