| Exercise-induced changes in degenerative mitral regurgitation. | |
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MedLine Citation:
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PMID: 20633822 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to quantify exercise-induced changes in patients with degenerative mitral regurgitation (MR), to examine the relationship between exercise-induced changes in MR and in systolic pulmonary artery pressure (PAP), and to identify their potential impact on symptom-free survival. BACKGROUND: MR severity can change during exercise in patients with functional MR. Quantified changes in MR severity during exercise remain undetermined in patients with degenerative MR. METHODS: Resting and bicycle exercise Doppler-echocardiography were performed in 61 asymptomatic patients (age 62+/-14 years) with moderate to severe degenerative MR (i.e., mitral valve prolapse or flail). Mitral regurgitation was quantified at rest and exercise with effective regurgitant orifice (ERO) area and regurgitant volume calculated with the proximal isovelocity surface area (EROP) and the quantitative Doppler (EROD) methods. RESULTS: At rest, EROP and EROD were well-correlated (r=0.87, p<0.0001), but EROD was larger than EROP (54+/-21 mm2 vs. 42+/-24 mm2, p<0.0001). During exercise, mean ERO and regurgitant volume markedly increased in 32% of patients by >or=10 mm2 and >or=15 ml, respectively. There was good correlation between exercise EROP and EROD (r=0.84, p<0.0001). Changes in systolic PAP were correlated with changes in ERO and regurgitant volume (r=0.59, p=0.02 and r=0.60, p=0.02). Patients with a marked increase in regurgitant volume during exercise had lower symptom-free survival than those in whom MR decreased or remained unchanged (p=0.0015). CONCLUSIONS: Degenerative MR might be dynamic and increases during exercise in one-third of patients. Marked changes in MR severity are associated with exercise-induced changes in systolic PAP and reduced symptom-free survival. |
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Authors:
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Julien Magne; Patrizio Lancellotti; Luc A Piérard |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 56 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-16 Completed Date: 2010-08-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 300-9 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, University Hospital Sart Tilman, University of Liège, Liège, Belgium. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cohort Studies Echocardiography, Doppler / methods Exercise / physiology* Exercise Test / methods* Female Follow-Up Studies Humans Male Middle Aged Mitral Valve Insufficiency / physiopathology*, ultrasonography* Prospective Studies |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 Jul 20;56(4):310-3
[PMID:
20633823
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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