Document Detail


Treadmill exercise in apparently asymptomatic patients with moderate or severe aortic stenosis: relationship between cardiac index and revealed symptoms.
MedLine Citation:
PMID:  20424150     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To test whether symptoms revealed on exercise testing in patients with moderate or severe aortic stenosis are associated with changes in left ventricular systolic function and to investigate the ability of resting measures to predict peak cardiac index. METHODS: In a prospective study of asymptomatic aortic stenosis, 38 patients with a median age of 63 years (range 29-83) and an effective aortic orifice area by the continuity equation of less than 1.5 cm(2) had echocardiography, measurement of blood B-type natriuretic peptide (BNP) level and exercise haemodynamic testing using an inert gas rebreathing device. RESULTS: Revealed symptoms occurred in 10 patients in whom peak cardiac index (p=0.002), stroke index (p=0.024) and maximum oxygen consumption (VO(2)) (p=0.003) were lower than in those without symptoms. Univariate predictors of peak cardiac index were Doppler tissue peak systolic velocity (p=0.004, r=0.45), the ratio of peak transmitral E velocity to Doppler tissue Ea velocity (p=0.039, r=-0.34) and log BNP (p<0.001, r=-0.71). The only independent predictor of peak cardiac index was the log BNP level (p<0.001, r=-0.71). CONCLUSIONS: Revealed symptoms on treadmill exercise in apparently asymptomatic aortic stenosis were associated with lower peak myocardial VO(2) and lower peak stroke index during exercise. The strongest resting predictor of revealed symptoms and of peak cardiac index was the blood BNP level.
Authors:
Ronak Rajani; Helen Rimington; John B Chambers
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-28     Completed Date:  2010-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  689-95     Citation Subset:  AIM; IM    
Affiliation:
Valve Study Group, Guy's and St Thomas Hospitals Foundation Trust, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Valve Stenosis / physiopathology*,  ultrasonography
Echocardiography
Exercise / physiology*
Exercise Test
Female
Hemodynamics / physiology*
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / metabolism
Prospective Studies
Risk Factors
Ventricular Dysfunction, Left / etiology*,  physiopathology,  ultrasonography
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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


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