Article (Scientific journals)
Exercise Testing and Stress Imaging in Valvular Heart Disease.
henri, Christine; Pierard, Luc; Lancellotti, Patrizio et al.
2014In Canadian Journal of Cardiology, 30 (9), p. 1012-1026
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Abstract :
[en] The role of exercise testing and stress imaging in the management of patients with valvular heart disease (VHD) is reviewed in this article. The American College of Cardiology/American Heart Association and the European Society of Cardiology/European Association of Cardiothoracic Surgery have recently put emphasis on the role of exercise testing to clarify symptom status and the use of stress imaging to assess the dynamic component of valvular abnormalities and unmask subclinical myocardial dysfunction that could be missed at rest. Recent studies have demonstrated the incremental prognostic value of exercise echocardiography for asymptomatic patients with severe aortic stenosis, moderate-severe mitral stenosis, and severe primary mitral regurgitation. In patients with low-flow, low-gradient aortic stenosis, dobutamine stress echocardiography is recommended to differentiate true severe from pseudosevere aortic stenosis. Data on the prognostic value of stress echocardiography in aortic regurgitation and functional mitral regurgitation are less robust. Data are sparse on the use of stress imaging in right-sided VHD, however recent studies using stress cardiovascular magnetic resonance imaging offer some prognostic information. Although the strongest recommendations for surgical treatment continue to be based on symptom status and resting left ventricular repercussions, stress imaging can be useful to optimize risk stratification and timing of surgery in VHD. Randomized clinical trials are required to confirm that clinical decision-making based on stress imaging can lead to improved outcomes.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
henri, Christine
Pierard, Luc ;  Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Lancellotti, Patrizio  ;  Université de Liège - ULiège > Département des sciences cliniques > Imagerie cardiaque fonctionnelle par échographie
Mongeon, Francois-Pierre
Pibarot, Philippe
Basmadjian, Arsene J.
Language :
English
Title :
Exercise Testing and Stress Imaging in Valvular Heart Disease.
Publication date :
2014
Journal title :
Canadian Journal of Cardiology
ISSN :
0828-282X
eISSN :
1916-7075
Publisher :
Elsevier, Oxford, United Kingdom
Volume :
30
Issue :
9
Pages :
1012-1026
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Available on ORBi :
since 08 October 2014

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