Exercise radionuclide angiography in patients with mitral stenosis: value of right ventricular response

We observed 26 patients with mitral stenosis and 19 normal volunteers with exercise gated radionuclide angiography. Although no differences were seen between normal subjects and patients with mitral stenosis at rest in left (LV) and right (RV) ventricular ejection fraction, significant differences were found for exercise change in ejection fraction for both ventricles, exercise time, exercise workload, and the percent change in LV end-diastolic, LV stroke, and RV end-systolic counts (ESC). Because nearly all of the normals (18/19) had a decrease in RVESC, patients with stenosis were divided into two groups according to whether RVESC increased or decreased. Significant differences were found between these two groups for age, New York Heart Association class, prevalence of atrial fibrillation, echocardiographic mitral valve area, and prognosis, that is, number undergoing catheterization and surgery. We conclude that exercise radionuclide angiography does yield information that has significant clinical and prognostic value in patients with mitral stenosis.