Introduction
Exercise echocardiography
Exercise echo in mitral regurgitation
Exercise echo in mitral stenosis
Materials and methods
Study population
Expert panel
Exercise echo protocol
Results
Mitral regurgitation
Patient characteristics
Baseline | MR | MS |
---|---|---|
Patient characteristics | ||
Study group | 14 | 14 |
Age (range) | 66 (31–78) | 56 (29–83) |
Gender: | ||
Male (%) | 50 | 29 |
Female (%) | 50 | 71 |
Left ventricular function | ||
Normal | 11 | 13 |
Dysfunctionala
| 3 | 1 |
Mitral valve disease | ||
Symptomatic | 14 | 12 |
Severity in rest: | ||
Severe | 1 | 1 |
Moderate | 4 | 11 |
Mild | 7 | 2 |
None | 2 | 0 |
Exercise protocol | ||
Semi-supine bicycle | 10 | 6 |
Alternative exercise testb
| 4 | 8 |
MR patient | Diagnosis at rest | Symptoms | Consider intervention at rest | LV function at rest | RVSP at rest | RVSP during stress | Diagnosis during stress | Intervention during stress | Decision based on | Additional value stress echo |
---|---|---|---|---|---|---|---|---|---|---|
1 | Mild | Yes | No | Normal | 27.6 | 60.0 | Severe | Yes | Severity and RVSP | Yes change |
2 | Mild | Yes | No | Normal | 25.0 | 46.0 | Moderate | No | Severity and RVSP | Yes confirmation |
3 | Mild | Yes | No | Normal | 22.3 | 51.0 | Mild | No | Severity and RVSP | Yes confirmation |
4 | Severe | Yes | Yes | Normal | 39.0 | 70.0 | Severe | Yes | Severity and RVSP | Yes confirmation |
5 | Mild | Yes | No | Normal | 27.4 | 40.0 | Moderate | No | Othera
| No |
6 | Mild | Yes | No | Reduced | NA | NA | Moderate | No | Othera
| No |
7 | Moderate | Yes | No | Reduced | 35.5 | 75.2 | Moderate | Yes | RVSP | Yes change |
8 | Mild | Yes | No | Normal | 33.3 | 50.7 | Moderate | No | Severity and RVSP | Yes confirmation |
9 | None | Yes | No | Normal | NA | 25.0 | Mild | No | Severity and RVSP | Yes confirmation |
10 | Mild | Yes | No | Reduced | 28.9 | 41.0 | Moderate | No | Severity and RVSP | Yes confirmation |
11 | None | Yes | No | Normal | 30.8 | 64.2 | Severe | Yes | Severity and RVSP | Yes change |
12 | Moderate | Yes | No | Normal | 30.5 | NA | Mild | No | Severity | Yes confirmation |
13 | Moderate | Yes | No | Normal | 27.6 | NA | Severe | Yes | Severity | Yes change |
14 | Moderate | Yes | No | Normal | 30.9 | 73.1 | Moderate | No | Severity | Yes confirmation |
Exercise echo
Clinical management
Mitral stenosis
Patient characteristics
MS patient | Diagnosis at rest | Symptoms | Consider intervention at rest | LV function at rest | RVSP at rest | Mean gradient at rest | RVSP during stress | Mean gradient during stress | Diagnosis during stress | Intervention during stress | Decision based on | Additional value stress echo |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Severe | Yes | Yes | Normal | 28.1 | 10.0 | 38.0 | 24 | Severe | Yes | Severity and mean gradient | Yes confirmation |
2 | Moderate | No | No | Normal | 45.6 | 4.9 | 50.0 | 4 | Moderate | No | Severity, RVSP and mean gradient | Yes confirmation |
3 | Moderate | Yes | No | Normal | 40.0 | 10.0 | 63.0 | 18 | Severe | Yes | Severity, RVSP and mean gradient | Yes change |
4 | Moderate | Yes | No | Normal | NA | 5.5 | NA | 9.5 | Moderate | No | Othera
| No |
5 | Moderate | Yes | No | Normal | 23.0 | 6.2 | 56.7 | 11 | Moderate | No | Othera
| No |
6 | Moderate | Yes | No | Reduced | 36.0 | 8.7 | 25.0 | 20 | Severe | Yes | Severity and mean gradient | Yes change |
7 | Moderate | Yes | No | Normal | 46.0 | 9.9 | 61.0 | 15 | Severe | Yes | Severity, RVSP and mean gradient | Yes change |
8 | Moderate | Yes | No | Normal | 30.9 | 4.5 | 38.0 | 10 | Moderate | No | Othera
| No |
9 | Moderate | Yes | No | Normal | 25.7 | 8.9 | 48.9 | 14 | Moderate | No | Othera
| No |
10 | Moderate | Yes | No | Normal | 50.0 | 9.0 | 86.0 | 23 | Severe | Yes | Severity, RVSP and mean gradient | Yes change |
11 | Mild | Yes | No | Normal | 37.0 | 3.5 | 77.0 | 8 | Moderate | No | Othera
| No |
12 | Moderate | Yes | No | Normal | 26.0 | 7.0 | 34.0 | 29 | Severe | Yes | Severity and mean gradient | Yes change |
13 | Mild | Yes | No | Normal | NA | 4.5 | NA | 13 | Moderate | No | Othera
| No |
14 | Moderate | No | No | Normal | 30.0 | 4.4 | 47.0 | 24 | Severe | Yes | Severity and mean gradient | Yes change |