Document Detail


Determinants of an abnormal response to exercise in patients with asymptomatic valvular aortic stenosis.
MedLine Citation:
PMID:  17604696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Patients with asymptomatic aortic stenosis (AS) and abnormal haemodynamic responses to exercise testing are at increased risk of cardiac events. This study assesses the Doppler echocardiographic determinants of a positive exercise test in a cohort of asymptomatic patients with AS. METHODS AND RESULTS: One hundred and twenty-eight patients with AS underwent quantitative Doppler echocardiographic measurements at rest and during exercise test. Of these patients, 60 had an abnormal response to exercise. Two independent determinants of an abnormal exercise response were selected in multivariate analysis: a larger increase in mean transaortic pressure gradient (P = 0.00014) and a limited contractile reserve-latent left ventricular dysfunction-as indicated by smaller changes in ejection fraction (P = 0.0002). Limiting symptoms were associated with greater increase in mean transaortic pressure gradient, smaller changes in systolic blood pressure and a lower ejection fraction at peak exercise. The increase in pressure gradient was associated with smaller exercise-induced changes in aortic valve area and in ejection fraction and new or worsening mitral regurgitation during exercise. CONCLUSION: Abnormal responses to exercise in asymptomatic AS patients are mediated by a larger increase in mean transaortic pressure gradient and/or a limited contractile reserve characterized by an inadequate increase in ejection fraction at exercise.
Authors:
Patrizio Lancellotti; Danai Karsera; Gabriele Tumminello; Florence Lebois; Luc A Piérard
Related Documents :
16728226 - Echocardiographic assessment during exercise of heart failure patients with cardiac res...
19944366 - Increased atrial contribution to left ventricular filling compensates for impaired earl...
18751466 - Does exercise echocardiography have an added value over exercise testing alone in asymp...
2502326 - Dynamic mitral regurgitation. an important determinant of the hemodynamic response to l...
9065946 - Quality of life in patients with cystic fibrosis.
12032406 - Plasma nitrite/nitrate and erythropoietin levels in cross-country skiers during altitud...
Publication Detail:
Type:  Journal Article     Date:  2007-06-30
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  9     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-20     Completed Date:  2008-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  338-43     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Sart Tilman, B-4000 Liège, Belgium. plancellotti@chu.ulg.ac.be
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Valve Stenosis / physiopathology*,  ultrasonography*
Echocardiography, Doppler
Exercise / physiology*
Exercise Test
Hemodynamics
Humans
Middle Aged
Prospective Studies
Rest / physiology
Stroke Volume

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


Previous Document:  Apheresis information management system (AMIS).
Next Document:  Myocardial contraction properties along the long and short axes of the left ventricle in isolated le...