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Left ventricular response to exercise in aortic stenosis: an exercise echocardiographic study
Sylvestre Maréchaux1, Pierre-Vladimir Ennezat, Thierry H LeJemtel
1Cardiology Hospital, Lille University Medical Center, CRHU Lille, Boulevard Pr J Leclerc, Lille, France.
Echocardiography (Mount Kisco, N.Y.)
|September 27, 2007
Summary
An abnormal left ventricular (LV) response during exercise in patients with severe aortic stenosis may indicate a poor outcome. Exercise echocardiography helps identify these patients and interpret exercise-induced symptoms.
Area of Science:
- Cardiology
- Echocardiography
- Aortic Stenosis
Background:
- Left ventricular (LV) systolic function can decline during exercise in aortic stenosis patients.
- Exercise testing is now recommended for asymptomatic aortic stenosis patients to assess the need for valve replacement.
- The clinical significance of abnormal LV response to exercise in this population is not well understood.
Purpose of the Study:
- To investigate the clinical implications of an abnormal LV response during exercise in patients with aortic stenosis.
Main Methods:
- 50 patients with severe aortic stenosis and normal resting LV systolic function underwent exercise echocardiography.
- LV response to exercise was monitored using 2D-Doppler echocardiography.
- Patients were followed for an average of 11 months for cardiac events.
Main Results:
- Twenty patients showed an abnormal LV response (decreased LV ejection fraction), while 30 had a normal response (increased LV ejection fraction).
- Abnormal LV response was associated with a higher likelihood of exercise-induced symptoms (80% vs. 27%).
- Patients with an abnormal LV response had significantly lower survival free of cardiac events.
Conclusions:
- Exercise echocardiography provides objective data for interpreting exercise-induced symptoms in severe aortic stenosis.
- An abnormal LV response to exercise may predict a poorer clinical outcome in these patients.
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