Exercise Testing in Aortic Stenosis: Safety, Tolerability, Clinical Benefits and Prognostic Value

Area of Science:

• Cardiology
• Clinical Medicine
• Diagnostic Testing

Background:

• Valvular heart disease (VHD) management requires accurate assessment of hemodynamic severity and patient functional capacity.
• Exercise testing aids in classifying stenosis or regurgitation severity and patient symptoms, crucial for surveillance and surgical timing.
• Aortic stenosis (AS) poses a significant risk of sudden death once symptoms manifest, underscoring the need for timely intervention.

Purpose of the Study:

• To review the benefits of exercise testing in patients diagnosed with aortic stenosis (AS).

Main Methods:

• Systematic literature search of the PubMed database.
• Inclusion of retrospective and prospective cohort studies.
• Focus on studies reporting safety, feasibility, and tolerability of exercise testing in VHD, particularly AS.

Main Results:

• Exercise testing is safe, feasible, and well-tolerated in patients with significant AS.
• A substantial proportion of patients develop symptoms during exercise testing.
• Serial exercise testing provides additional prognostic information beyond a single baseline test.

Conclusions:

• Exercise testing is an underutilized tool in AS management.
• Routine exercise testing should be employed to refine hemodynamic severity assessment in AS patients.
• This testing modality is vital for optimizing patient surveillance and surgical decision-making.