Exercise behavior of degenerative mitral stenosis

Horn, Benjamin; Lo, Kevin Bryan; Sengupta, Shantanu; Pressman, Gregg S.

doi:10.1007/s10554-020-01898-2

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…The same differences were seen with sPAP, derived from tricuspid regurgitation velocities. As a result, individuals with MAC had a reduced exercise time and were more likely to stop due to dyspnoea 44…”

Section: Specific Valvular Lesionsmentioning

confidence: 99%

Physical activity and exercise recommendations for patients with valvular heart disease

Chatrath

Papadakis

2022

Heart

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There is a paucity of studies looking at the natural history of valvular heart disease (VHD) in exercising individuals, and exercise recommendations are largely based on expert consensus. All individuals with VHD should be encouraged to avoid sedentary behaviour by engaging in at least 150 min of physical activity every week, including strength training. There are generally no exercise restrictions to individuals with mild VHD. Regurgitant lesions are better tolerated compared with stenotic lesions and as such the recommendations are more permissive for moderate-to-severe regurgitant VHD. Individuals with severe aortic regurgitation can still partake in moderate-intensity exercise provided the left ventricle (LV) and aorta are not significantly dilated and the ejection fraction (EF) remains >50%. Similarly, individuals with severe mitral regurgitation can partake in moderate-intensity exercise if the LV end-diastolic diameter <60 mm, the EF ≥60%, resting pulmonary artery pressure <50 mm Hg and there is an absence of arrhythmias on exercise testing. Conversely, individuals with severe aortic or mitral stenosis are advised to partake in low-intensity exercise. For individuals with bicuspid aortic valve, in the absence of aortopathy, the guidance for tricuspid aortic valve dysfunction applies. Mitral valve prolapse has several clinical, ECG and cardiac imaging markers of increased arrhythmic risk; and if any are present, individuals should refrain from high-intensity exercise.

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Section: Specific Valvular Lesionsmentioning

confidence: 99%

Physical activity and exercise recommendations for patients with valvular heart disease

Chatrath

Papadakis

2022

Heart

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“…TMG rose significantly with exercise (17.3

8.4 vs. 5.5

2.5 mmHg at baseline, p

0.0001) and peak PASP exceeded 60 mmHg in 72% of DMS patients versus 26% of controls ( p = 0.01). The authors concluded that MAC may be an under-recognized cause of dyspnea and exercise intolerance in older patients [ 47 ]. If exercise cannot be performed, Dobutamine Stress Echocardiography (DSE) may be useful [ 48 ].…”

Section: Utility Of Exercise/stress Echocardiography Of Hemodynamic ...mentioning

confidence: 99%

Degenerative Mitral Stenosis—Diagnostic Challenges and Future Directions

Joury¹,

Puleo²,

Golive³

et al. 2022

Rev. Cardiovasc. Med.

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Determining the severity of stenosis in degenerative mitral stenosis (DMS) is fraught with challenges. Neither a high trans-mitral gradient nor a small valve area calculation is sufficiently diagnostic for DMS due to variable left atrial and left ventricular compliance in the setting of diastolic dysfunction, and the variable flow seen in patients with chronic kidney disease (i.e., high flow state) and elderly women (low flow state). Three-dimensional measurement of mitral valve area may be underestimated due to shadowing from basal calcium, and mitral valve annulus (MVA) by continuity equation (CEQ) or dimensionless mitral valve index can be erroneous in the presence of significant regurgitation of left-sided valves. The proposed dimensionless mitral stenosis index (DMSI) can be an easy echocardiographic tool to use in daily practice but needs further validation and is limited in the setting of significant regurgitation of left sided valves. Mean trans-mitral gradients >8 mmHg and pulmonary artery pressure >50 mmHg are independent predictors of mortality in those with MVA <1.5 cm 2 derived by CEQ. In patients who have symptoms that are out of proportion to the degree of stenosis reported, exercise stress testing may help determine the physiologic effects of the stenotic valve. A combination of MVA by CEQ or DMSI and mean transmitral gradient at a given left ventricle stroke volume (flow) should be evaluated in larger studies.

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Estenosis Mitral: Caso Clínico

Cárdenas Álvarez,

Salas Contreras,

Moyano Brito

2023

ConcienciaDigital

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Introducción. La estenosis y la insuficiencia pulmonar, son patologías que ocasionan alteraciones en el flujo de sangre dentro de las cavidades derechas del corazón. Se presentan mayoritariamente como defectos congénitos, pero en una gran cantidad de pacientes no son diagnosticadas sino hasta llegar a la edad adulta; debido a la poca sintomatología que usualmente presentan y debido al gran periodo de latencia que tienen de forma asintomática. Objetivo. Determinar las principales manifestaciones clínicas y los métodos diagnósticos de las patologías de la válvula pulmonar a través de un caso clínico, con el fin de ayudar a facilitar sus diagnósticos tempranos. Metodología. Estudio de caso clínico de tipo descriptivo, retrospectivo. La recolección de la información del caso se realizará mediante la revisión de la historia clínica. La expectativa del siguiente trabajo de investigación es identificar las principales causas, síntomas y signos, el diagnóstico, tratamiento y prevención de la estenosis e insuficiencia pulmonar. Resultados. Presentamos el caso de una femenina de 34 años edad con antecedente de valvulopatía pulmonar en la infancia y 24 horas de evolución de disnea más dolor retroesternal. Se realizan los exámenes complementarios y se diagnostica una estenosis con insuficiencia pulmonar. Se Realiza una cirugía de reemplazo valvular y es dada de alta con buen pronóstico. Conclusión. La principal manifestación de las enfermedades de la válvula pulmonar son manifestaciones características de insuficiencia cardiaca derecha y retención de líquidos. El principal estudio diagnóstico de las enfermedades de la válvula pulmonar es la ecocardiografía más estudio Doppler. El tratamiento de elección en estenosis e insuficiencia pulmonar cuando los síntomas son graves es el reemplazo valvular. Las enfermedades valvulares pulmonares cuando son diagnosticadas correctamente e intervenidas a tiempo, suelen tener una remisión muy buena y el pronóstico es favorable. Área de estudio general: medicina. Área de estudio específica: cardiología. Tipo de estudio: Casos clínicos.

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Exercise behavior of degenerative mitral stenosis

Cited by 4 publications

References 16 publications

Physical activity and exercise recommendations for patients with valvular heart disease

Physical activity and exercise recommendations for patients with valvular heart disease

Degenerative Mitral Stenosis—Diagnostic Challenges and Future Directions

Estenosis Mitral: Caso Clínico

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