Document Detail


Exercise evaluation of prosthetic heart valves by Doppler echocardiography: comparison with catheterization studies.
MedLine Citation:
PMID:  10149888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although valve replacement remains the cornerstone of treatment for critical heart valve dysfunction, problems including thromboembolism, infection, and primary failure of the prosthesis remain. Resting studies of valve hemodynamics are sometimes insufficient to reveal valve dysfunction. Early studies using cardiac catheterization focused on changes in prosthetic function seen with various types of exercise or drug-induced stress. These studies suffered from an inability to adequately stress catheterized patients and were cumbersome to the patient and the investigator. With the introduction of Doppler echocardiography, however, studies could be performed after significant exercise with low risk and increased ease. Using echocardiography, reports of exercise-induced changes in aortic and mitral valve hemodynamics have appeared. Over 600 patients have been studied using Doppler echocardiography. In the aortic position, all prostheses studied have a mild peak instantaneous gradient (18-26 mmHg) at rest, which increases with exercise (35-63 mmHg). No significant differences between the four models of mechanical prostheses studied are found. The gradients achieved with exercise do not appear to be related to the heart rate achieved or duration of exercise. Smaller prostheses are associated with larger gradients; however, the correlation was not strong. All mitral valve prostheses studied are also mildly stenotic at rest (range of mean gradients 2.3-7.1 mmHg) and become moderately stenotic with exercise (range 5.1-16.5). Although the lowest gradients are seen with St. Jude Medical and Medtronic Hall prostheses, their gradients are not significantly less than with other valves.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
F A Dressler; A J Labovitz
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  9     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-08-27     Completed Date:  1992-08-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  235-41     Citation Subset:  T    
Affiliation:
Department of Internal Medicine, St. Louis University Medical Center, Missouri.
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MeSH Terms
Descriptor/Qualifier:
Aortic Valve / surgery
Echocardiography, Doppler / methods*
Exercise Test / methods*
Heart Catheterization
Heart Valve Prosthesis*
Hemodynamics
Humans
Mitral Valve / surgery
Prosthesis Failure

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


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