Early Hemodynamic Changes Versus Peak Values: What Is More Useful to Predict Occurrence of Dyspnea During Stress Echocardiography in Patients with Asymptomatic Mitral Stenosis?

Exercise Testing and Stress Imaging in Valvular Heart Disease

“…These observations suggest that the evaluation of changes in MTMG and the pattern of SPAP progression, especially during the first stage of exercise, play an important role in the evaluation of exercise tolerance and underline the benefits of studying hemodynamic changes at every stage of exercise, rather than simply comparing rest and peak exercise values. 54 Atrioventricular compliance. Resting and particularly exercise SPAP could be dramatically different in patients with comparable mitral valve areas but different atrioventricular (AtV) compliance.…”

Echocardiographic Assessment of Degenerative Mitral Stenosis: A Diagnostic Challenge of an Emerging Cardiac Disease

“…80 Because exercise is more physiologic, it is the recommended way of stress for evaluation of MS. ) who claim to be asymptomatic with daily activities would develop dyspnea during a stress test. 81 Contrary to the previous guidelines, 82 current VHD guidelines do not include PA systolic pressure (peak exercise) as a criterion for diagnosis of severe MS. However a rise in PA systolic pressure to >60 mmHg to 70 mmHg with exercise should warrant more detailed evaluation for MS. 5 Serial evaluation of PA systolic pressure during exercise carries importance as well.…”

“…However a rise in PA systolic pressure to >60 mmHg to 70 mmHg with exercise should warrant more detailed evaluation for MS. 5 Serial evaluation of PA systolic pressure during exercise carries importance as well. Brochet et al demonstrated that the rapid and high progression of TMPG and PA systolic pressure at early exercise (compared to peak) is a strong predictor of dyspnea during a stress test in patients with MS. 81 Conversely, PA systolic pressures at peak exercise was not a predictor of exercise limiting symptoms.…”

Exercise Testing and Stress Imaging in Mitral Valve Disease

“…Finally, the authors concluded that, in addition to conventional management, DSE might increase the detection of high-risk patients presenting moderate mitral stenosis. More recently, Brochet et al [13] explored 48 "asymptomatic" patients presenting moderate to severe MS. Exercise echocardiography allowed identification of patients who underestimated their symptoms, since 46% of them described dyspnea during test.…”