Article (Scientific journals)
Prognostic importance of quantitative exercise Doppler echocardiography in asymptomatic valvular aortic stenosis
Lancellotti, Patrizio; Lebois, Florence; Simon, Marc et al.
2005In Circulation, 112 (9 Suppl.), p. 377-I382
Peer Reviewed verified by ORBi
 

Files


Full Text
LANCELLOTTI_Circulation_2005_1377.pdf
Publisher postprint (402.38 kB)
Request a copy

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
aortic valve; echocardiography; exercise; prognosis
Abstract :
[en] BACKGROUND: In patients with asymptomatic valvular aortic stenosis, exercise testing may help to stratify the clinical risk. However, data are limited, and the role of quantitative exercise Doppler echocardiography has never been investigated. METHODS AND RESULTS: Sixty-nine consecutive patients with severe asymptomatic aortic stenosis (aortic valve area <1 cm2) who prospectively underwent quantitative Doppler echocardiographic measurements at rest and during semisupine exercise test were followed up for 15+/-7 months. Of these, 26 had an abnormal response to exercise [occurrence of > or =1 of the following findings: angina, dyspnea, > or =2 mm ST segment depression, or fall or small (<20 mm Hg) rise in systolic blood pressure during the test] and 18 presented cardiac events during follow-up (symptoms in 2 patients, acute pulmonary edema in 2, aortic valve replacement in 12, and cardiac death in 2). In univariate analysis, patients who had cardiac events exhibited a higher increase in both peak (29+/-16 versus 22+/-14 mm Hg; P=0.019) and mean (23+/-8 versus 12+/-7 mm Hg; P=0.000003) transvalvular pressure gradients, whereas the left ventricular ejection fraction reached at peak stress was lower. These patients experienced more frequently symptoms during exercise (14 of 18 versus 12 of 51; P=0.0008). By multivariate Cox regression analysis, independent predictors of cardiac events were as follows: an increase in mean transaortic pressure gradient by > or =18 mm Hg during exercise (P=0.0015), an abnormal exercise test (P=0.0026), and an aortic valve area <0.75 cm2 (P=0.0031). Exercise Doppler echocardiographic findings provided incremental prognostic value over resting echocardiographic and exercise electrocardiographic parameters. CONCLUSIONS: Quantitative Doppler exercise echocardiography could be useful to identify a high-risk subset of patients with asymptomatic valvular aortic stenosis and help for clinical decision making.
Disciplines :
Hematology
Cardiovascular & respiratory systems
Author, co-author :
Lancellotti, Patrizio  ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Lebois, Florence ;  Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Simon, Marc
Tombeux, Christophe ;  Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Chauvel, Christophe
Pierard, Luc ;  Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Language :
English
Title :
Prognostic importance of quantitative exercise Doppler echocardiography in asymptomatic valvular aortic stenosis
Publication date :
30 August 2005
Journal title :
Circulation
ISSN :
0009-7322
eISSN :
1524-4539
Publisher :
Lippincott Williams & Wilkins, Philadelphia, United States - Pennsylvania
Volume :
112
Issue :
9 Suppl.
Pages :
I377-I382
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 21 June 2013

Statistics


Number of views
26 (5 by ULiège)
Number of downloads
2 (1 by ULiège)

Scopus citations®
 
279
Scopus citations®
without self-citations
225
OpenCitations
 
0

Bibliography


Similar publications



Contact ORBi