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Exercise Testing and Stress Imaging in Mitral Valve Disease.

Damien Voilliot1,2,3, Patrizio Lancellotti4,5,6

  • 1Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France.

Current Treatment Options in Cardiovascular Medicine
|March 15, 2017
PubMed
Summary

Mitral valve disease, including stenosis and regurgitation, can cause pulmonary hypertension and heart failure. Exercise echocardiography is a sensitive tool for identifying high-risk patients needing early intervention for better outcomes.

Keywords:
EchocardiographyExerciseMitral valve diseaseValvular heart disease

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Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Echocardiography

Background:

  • Mitral valve disease, encompassing mitral stenosis and regurgitation, is a common valvulopathy.
  • These conditions increase left atrial pressure, leading to pulmonary hypertension, right heart failure, and potentially left ventricular dysfunction.
  • Current interventions are often guided by symptoms and resting echocardiography, which may not always yield optimal surgical outcomes.

Purpose of the Study:

  • To highlight the limitations of resting echocardiography in managing mitral valve disease.
  • To emphasize the diagnostic value of exercise testing, particularly exercise echocardiography, in identifying high-risk patients.
  • To advocate for early intervention based on exercise testing findings for improved patient outcomes.

Main Methods:

  • Review of current clinical practices and diagnostic tools for mitral valve disease.
  • Analysis of the sensitivity of resting versus exercise testing in risk stratification.
  • Discussion of the role of percutaneous interventions and valve replacement.

Main Results:

  • Resting echocardiography may not identify all patients who would benefit from early intervention.
  • Abnormal exercise testing is more sensitive in detecting high-risk patients with mitral valve disease.
  • Exercise echocardiography has emerged as a critical tool in the last decade for managing these patients.

Conclusions:

  • Early intervention guided by abnormal exercise testing may improve outcomes in patients with mitral valve disease.
  • Exercise echocardiography plays a crucial role in the contemporary management of mitral valve disease.
  • Optimizing surgical timing based on comprehensive assessment, including exercise capacity, is essential.