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Right ventricular function at rest and during exercise in aortic and mitral valve disease
Journal of the American College of Cardiology
|January 1, 1985
Summary
Right ventricular ejection fraction is often reduced in patients with aortic or mitral valve disease, even at rest. Exercise does not typically improve right ventricular function, indicating significant impairment in these patients.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Valvular Heart Disease
Background:
- Symptomatic aortic and mitral valve disease can significantly impact cardiac function.
- Right ventricular (RV) function is crucial for overall cardiovascular health, but its assessment in valvular heart disease is complex.
Purpose of the Study:
- To evaluate right ventricular (RV) function at rest and during exercise in patients with symptomatic aortic or mitral valve disease.
- To determine the relationship between RV function, pulmonary artery pressure, and central venous pressure in this patient group.
Main Methods:
- Assessed right ventricular ejection fraction (RVEF) at rest and during supine bicycle exercise in 36 patients with symptomatic aortic/mitral valve disease.
- Measured central venous pressure (CVP) and pulmonary artery pressure (PAP) at rest and during maximal exercise.
Main Results:
- Reduced RVEF (<45%) was observed in 22/36 patients at rest and 12/17 during exercise.
- RVEF failed to increase by >5% with exercise in all 17 patients assessed.
- Significant inverse correlations were found between rest RVEF and mean PAP (r=-0.47) and rest RVEF and mean CVP (r=-0.39).
Conclusions:
- Right ventricular function is not solely determined by pulmonary artery pressure in patients with aortic and mitral valve disease.
- A normal RVEF at rest does not exclude pulmonary hypertension in patients with valvular heart disease.
- RV dysfunction is common and exercise intolerance is significant in this population.