Sveeta Badiani, Jet van Zalen, Sahar Alborikan, Aeshah Althunayyan, David Bruce, Thomas Treibel, Sanjeev Bhattacharyya, Nikhil Patel, Guy Lloyd
{"title":"Exercise capacity in moderate aortic stenosis: a cardiopulmonary stress echocardiography study.","authors":"Sveeta Badiani, Jet van Zalen, Sahar Alborikan, Aeshah Althunayyan, David Bruce, Thomas Treibel, Sanjeev Bhattacharyya, Nikhil Patel, Guy Lloyd","doi":"10.1186/s44156-025-00070-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with moderate aortic stenosis (AS) may experience symptoms and adverse outcomes. The aim of this study was to determine whether patients with moderate AS exhibited objective evidence of exercise limitation, compared with age and sex matched controls and if so, to determine which echocardiographic parameters predicted exercise ability.</p><p><strong>Methods: </strong>This was a prospective case control study of patients with moderate AS (peak velocity (Vmax) 3.0-3.9 m/s, mean gradient (MG) 20-39mmHg, aortic valve area (AVA)1.1-1.5cm<sup>2</sup> ) and left ventricular ejection fraction (LVEF) ≥ 55%. All patients underwent cardiopulmonary stress echocardiography.</p><p><strong>Results: </strong>25 patients with moderate AS (Vmax 3.5 ± 0.2mmHg, mean gradient 28 ± 5mmHg, AVA 1.2 ± 0.1cm<sup>2</sup>, LVEF 61 ± 4%) were compared with 25 controls. % predicted oxygen uptake efficiency slope (OUES), % predicted O<sub>2</sub> pulse and VO<sub>2</sub> at anaerobic threshold (AT) were significantly lower in patients compared with controls (OUES 79 ± 15 vs. 89 ± 15%, p = 0.013). VO<sub>2</sub> did not significantly differ between cases and controls.</p><p><strong>Conclusion: </strong>Objective measures of exercise capacity including OUES, O<sub>2</sub> pulse and VO<sub>2</sub> at AT are significantly lower in patients with moderate AS compared with controls, suggesting that these parameters may be more useful than VO<sub>2</sub> where patients may be unable to complete a maximal exercise test. Risk stratification using cardiopulmonary exercise echocardiography may help to identify patients with moderate AS who are at increased risk of cardiovascular events and should be considered for more intensive surveillance and intervention.</p><p><strong>Trial registration: </strong>Clinical trial number MRC 0225 IRAS 207395.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"12 1","pages":"6"},"PeriodicalIF":3.2000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881479/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echo Research and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s44156-025-00070-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Patients with moderate aortic stenosis (AS) may experience symptoms and adverse outcomes. The aim of this study was to determine whether patients with moderate AS exhibited objective evidence of exercise limitation, compared with age and sex matched controls and if so, to determine which echocardiographic parameters predicted exercise ability.
Methods: This was a prospective case control study of patients with moderate AS (peak velocity (Vmax) 3.0-3.9 m/s, mean gradient (MG) 20-39mmHg, aortic valve area (AVA)1.1-1.5cm2 ) and left ventricular ejection fraction (LVEF) ≥ 55%. All patients underwent cardiopulmonary stress echocardiography.
Results: 25 patients with moderate AS (Vmax 3.5 ± 0.2mmHg, mean gradient 28 ± 5mmHg, AVA 1.2 ± 0.1cm2, LVEF 61 ± 4%) were compared with 25 controls. % predicted oxygen uptake efficiency slope (OUES), % predicted O2 pulse and VO2 at anaerobic threshold (AT) were significantly lower in patients compared with controls (OUES 79 ± 15 vs. 89 ± 15%, p = 0.013). VO2 did not significantly differ between cases and controls.
Conclusion: Objective measures of exercise capacity including OUES, O2 pulse and VO2 at AT are significantly lower in patients with moderate AS compared with controls, suggesting that these parameters may be more useful than VO2 where patients may be unable to complete a maximal exercise test. Risk stratification using cardiopulmonary exercise echocardiography may help to identify patients with moderate AS who are at increased risk of cardiovascular events and should be considered for more intensive surveillance and intervention.
Trial registration: Clinical trial number MRC 0225 IRAS 207395.
期刊介绍：
Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
