Document Detail

Left ventricular response to exercise in aortic stenosis: an exercise echocardiographic study.
MedLine Citation:
PMID:  17894574     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: While normal at rest, left ventricular (LV) systolic function may become abnormal during exercise in patients with aortic stenosis. Once contraindicated in patients with aortic stenosis, exercise testing is now recommended in asymptomatic patients with aortic stenosis to elicit symptoms and thereby ascertain the need for aortic valve replacement. However, the clinical significance of an abnormal LV response to exercise in asymptomatic patients with aortic stenosis remains unknown. OBJECTIVE: The aim of this study was to evaluate the clinical implications of an abnormal LV response during exercise in the setting of aortic stenosis. METHODS: We monitored the LV response to exercise by 2D-Doppler echocardiography during a symptom limited semirecumbent bicycle exercise in 50 patients with tight aortic stenosis (aortic valve area < or = 1.0 cm(2)) and a normal LV systolic function (LV ejection fraction, EF > or = 50%) and followed them for an average of 11 months. RESULTS: Twenty patients had an abnormal LV response to exercise with a mean decrease in LV EF from 64 +/- 10 to 53 +/- 12% while 30 patients had a normal LV response to exercise with a mean increase in LV EF from 62 +/- 7 to 70 +/- 8%. Patients with an abnormal LV response during exercise were more likely to develop symptoms during exercise than patients with a normal LV response: 80% versus 27% (P< 0.0001). The survival free of cardiac events was significantly lower in patients with abnormal LV response to exercise than in patients with a normal response (P = 0.03). CONCLUSION: Exercise echocardiography provides objective data that facilitate interpretation of exercise elicited symptoms in asymptomatic patients with severe aortic stenosis. In addition, an abnormal LV response to exercise may predict a poor outcome.
Sylvestre Maréchaux; Pierre-Vladimir Ennezat; Thierry H LeJemtel; Anne-Sophie Polge; Pascal de Groote; Philippe Asseman; Rémi Nevière; Thierry Le Tourneau; Ghislaine Deklunder
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  24     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-26     Completed Date:  2008-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  955-9     Citation Subset:  IM    
Cardiology Hospital, Lille University Medical Center, CRHU Lille, Boulevard Pr J Leclerc, Lille, France.
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MeSH Terms
Aortic Valve Stenosis / physiopathology*,  ultrasonography*
Chi-Square Distribution
Echocardiography, Doppler*
Exercise Test*
Predictive Value of Tests
Statistics, Nonparametric
Survival Analysis
Ventricular Dysfunction, Left / physiopathology,  ultrasonography

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

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