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Exercise testing in patients with asymptomatic moderate or severe aortic stenosis
Sahrai Saeed1,2, Ronak Rajani1, Reinhard Seifert2
1Cardiothoracic Centre, Guy's & St Thomas' Hospital, London, UK.
Treadmill exercise testing is safe for patients with aortic stenosis (AS). Serial testing effectively reveals symptoms and provides crucial prognostic information for managing AS outcomes.
Area of Science:
- Cardiology
- Clinical Medicine
- Diagnostic Testing
Background:
- Aortic stenosis (AS) is a significant valvular heart disease.
- Assessing prognosis in asymptomatic AS patients is clinically important.
- Exercise testing can reveal symptoms indicative of AS severity.
Purpose of the Study:
- To evaluate the safety and tolerability of treadmill exercise testing (ETT) in patients with moderate to severe AS.
- To determine the association between symptoms revealed during ETT and clinical outcomes.
Main Methods:
- Retrospective cohort study of 316 patients with moderate to severe AS.
- Patients underwent echocardiography and modified Bruce exercise treadmill tests (ETTs).
- Outcomes included aortic valve replacement (AVR) and all-cause mortality.
Main Results:
- ETT was safe and well-tolerated, with no serious adverse events.
- Symptom prevalence during ETT was 29% at baseline, higher in severe AS.
- Event-free survival at 24 months was significantly lower in patients with revealed symptoms (46%) versus without (70%).
Conclusions:
- Treadmill exercise testing is a safe and tolerable diagnostic tool for moderate to severe AS.
- Serial ETT is valuable for uncovering latent symptoms and enhancing prognostic accuracy.
- ETT findings provide incremental prognostic information beyond baseline assessment.
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Purposes
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