Reference : Exercise Echocardiography in Asymptomatic Patients with Severe Aortic Stenosis and Pr...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
Exercise Echocardiography in Asymptomatic Patients with Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction.
Henri, Christine [> >]
Lancellotti, Patrizio mailto [Université de Liège - ULiège > Département des sciences cliniques > Imagerie cardiaque fonctionnelle par échographie >]
Journal of Cardiovascular Ultrasound
[en] Aortic stenosis ; Exercise echocardiography ; Exercise testing
[en] The management of asymptomatic patients with severe aortic stenosis (AS) remains controversial. Recent series reported that early aortic valve replacement might be associated with improved clinical outcomes. However, the risk-benefit ratio should be carefully evaluated and early surgery only be proposed to a subset of asymptomatic patients considered at higher risk. Exercise echocardiography can help unmask symptomatic patients combined with assessment of the hemodynamic consequences of AS. Recent studies have demonstrated that exercise echocardiography can provide incremental prognostic value to identify patients who may benefit most from early surgery. In "truly" asymptomatic patients, an increase in mean aortic gradient >/= 18-20 mmHg, a limited left ventricular contractile reserve or a pulmonary hypertension during exercise are predictive parameters of adverse cardiac events. Exercise echocardiography is low-cost, safe and available in many referral centers, and does not expose patients to radiation. The purpose of this article is to describe the role of exercise testing and echocardiography in the management of asymptomatic patients with severe AS and preserved left ventricular ejection fraction.

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