Document Detail

Determinants of an abnormal response to exercise in patients with asymptomatic valvular aortic stenosis.
MedLine Citation:
PMID:  17604696     Owner:  NLM     Status:  MEDLINE    
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.
Patrizio Lancellotti; Danai Karsera; Gabriele Tumminello; Florence Lebois; Luc A Piérard
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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    
Department of Cardiology, University Hospital Sart Tilman, B-4000 Liège, Belgium.
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MeSH Terms
Aged, 80 and over
Aortic Valve Stenosis / physiopathology*,  ultrasonography*
Echocardiography, Doppler
Exercise / physiology*
Exercise Test
Middle Aged
Prospective Studies
Rest / physiology
Stroke Volume

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

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