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Pruebas de esfuerzo en estenosis aórtica asintomática

Björn Redfors1, Philippe Pibarot1, Linda D Gillam1

  • 1From Clinical Trials Center, Cardiovascular Research Foundation, New York (B.R., D.B., M.B.L., P.G.); Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); Pulmonary Hypertension and Vascular Biology Research Group, Laval University, Québec, Canada (P.P.); Gagnon Cardiovascular Institute, Morristown Medical Center, NJ (L.D.G., P.G.); Columbia University Medical Center, New York (D.B., M.B.L., P.G.); Leiden University Medical Center, The Netherlands (J.J.B.); Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN (B.R.L.); Northwestern University Feinberg School of Medicine, Chicago, IL (R.O.B.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.T.O.); and Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Québec, Canada (P.G.).

Circulation
|May 17, 2017
PubMed
Resumen

Las pruebas de esfuerzo pueden ayudar a evaluar el riesgo en pacientes con estenosis aórtica, guiando el momento de la cirugía de reemplazo de válvula aórtica. Este enfoque ayuda a una mejor estratificación del riesgo para las personas asintomáticas.

Palabras clave:
Estenosis de la aortaVálvula aórticareemplazo de la válvula aórticaPrueba de ejercicioel pronósticoprueba de resistencia

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Área de la Ciencia:

  • Cardiología
  • Cirugía cardíaca
  • Imágenes de diagnóstico

Sus antecedentes:

  • La estenosis aórtica es una enfermedad prevalente de la válvula cardíaca en adultos.
  • La estenosis aórtica severa sintomática requiere el reemplazo inmediato de la válvula aórtica.
  • La estratificación del riesgo es crucial para el manejo de pacientes asintomáticos.

Objetivo del estudio:

  • Revisar los datos actuales sobre las pruebas de esfuerzo en la estenosis aórtica.
  • Evaluar el papel de las pruebas de resistencia en la estratificación del riesgo.
  • Explorar su potencial para guiar el tiempo de reemplazo de la válvula aórtica.

Principales métodos:

  • Revisión completa de la literatura sobre las pruebas de esfuerzo en la estenosis aórtica.
  • Análisis de los datos relativos a la estratificación del riesgo y los resultados para los pacientes.
  • Síntesis de las pruebas para orientar la intervención quirúrgica.

Principales resultados:

  • Las pruebas de esfuerzo son una herramienta valiosa para estratificar el riesgo de los pacientes asintomáticos con estenosis aórtica.
  • Ayuda a identificar a los pacientes que pueden beneficiarse de una intervención más temprana.
  • Los datos apoyan su uso en combinación con otros factores clínicos.

Conclusiones:

  • Las pruebas de esfuerzo ofrecen una estrategia razonable para la estratificación del riesgo en la estenosis aórtica.
  • Puede ayudar a los médicos a determinar el momento óptimo para el reemplazo de la válvula aórtica.
  • La investigación adicional puede refinar su aplicación en la toma de decisiones clínicas.