Stress Echocardiogram in Asymptomatic Severe Aortic Stenosis

Overview

Journal Heart Views

Specialty Cardiology & Vascular Diseases

Date 2022 Jun 27

PMID 35757449

Authors

Asad I I Abusweireh

Hakam Abdallah Alzaeem

Affiliations

Soon will be listed here.

Abstract

Aortic stenosis (AS) is one of the most common adult valve diseases. Therefore, current guidelines recommend prompt aortic valve intervention once symptoms occur. However, AS is predominantly a disease of the elderly, and these people may be underreporting their symptoms, have other comorbidities, or have a low level of exertion at the baseline or they might make a subconscious adjustment of their activities. Hence, stress testing can be a vital and objective tool to uncover their symptoms and prognosticate.

Citing Articles

Biomechanical Evaluation of Aortic Valve Stenosis by Means of a Virtual Stress Test: A Fluid-Structure Interaction Study.

Govindarajan V, Kolanjiyil A, Wanna C, Kim H, Prakash S, Chandran K Ann Biomed Eng. 2023; 52(2):414-424.

PMID: 37957528 DOI: 10.1007/s10439-023-03389-6.

References

Ennezat P, Malergue M, Le Jemtel T, Abergel E . Watchful waiting care or early intervention in asymptomatic severe aortic stenosis: Where we are. Arch Cardiovasc Dis. 2020; 114(1):59-72. DOI: 10.1016/j.acvd.2020.07.002. View

Nishimura R, Otto C, Bonow R, Carabello B, Erwin 3rd J, Guyton R . 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 129(23):e521-643. DOI: 10.1161/CIR.0000000000000031. View

Das P, Rimington H, Smeeton N, Chambers J . Determinants of symptoms and exercise capacity in aortic stenosis: a comparison of resting haemodynamics and valve compliance during dobutamine stress. Eur Heart J. 2003; 24(13):1254-63. DOI: 10.1016/s0195-668x(03)00235-5. View

Olaf S, Debora B, Ricarda B, Gunnar B, Jochen K, Schimke I . Exercise tolerance in asymptomatic patients with moderate-severe valvular heart disease and preserved ejection fraction. Arch Med Sci. 2013; 8(6):1018-26. PMC: 3542492. DOI: 10.5114/aoms.2012.32409. View

Sonaglioni A, Lombardo M, Baravelli M, Trotta G, Sommese C, Anza C . Exercise stress echocardiography with tissue Doppler imaging in risk stratification of mild to moderate aortic stenosis. Int J Cardiovasc Imaging. 2015; 31(8):1519-27. DOI: 10.1007/s10554-015-0724-9. View

Vahanian A, Alfieri O, Andreotti F, Antunes M, Baron-Esquivias G, Baumgartner H . Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012; 33(19):2451-96. DOI: 10.1093/eurheartj/ehs109. View

Martinsson A, Li X, Andersson C, Nilsson J, Smith J, Sundquist K . Temporal trends in the incidence and prognosis of aortic stenosis: a nationwide study of the Swedish population. Circulation. 2015; 131(11):988-94. DOI: 10.1161/CIRCULATIONAHA.114.012906. View

Yingchoncharoen T, Gibby C, Rodriguez L, Grimm R, Marwick T . Association of myocardial deformation with outcome in asymptomatic aortic stenosis with normal ejection fraction. Circ Cardiovasc Imaging. 2012; 5(6):719-25. DOI: 10.1161/CIRCIMAGING.112.977348. View

Donal E, Thebault C, OConnor K, Veillard D, Rosca M, Pierard L . Impact of aortic stenosis on longitudinal myocardial deformation during exercise. Eur J Echocardiogr. 2011; 12(3):235-41. DOI: 10.1093/ejechocard/jeq187. View

10.

Lancellotti P, Magne J, Donal E, OConnor K, Dulgheru R, Rosca M . Determinants and prognostic significance of exercise pulmonary hypertension in asymptomatic severe aortic stenosis. Circulation. 2012; 126(7):851-9. DOI: 10.1161/CIRCULATIONAHA.111.088427. View

11.

Lindman B, Dweck M, Lancellotti P, Genereux P, Pierard L, OGara P . Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement. JACC Cardiovasc Imaging. 2019; 13(2 Pt 1):481-493. DOI: 10.1016/j.jcmg.2019.01.036. View

12.

Tongue A, Dumesnil J, Laforest I, Theriault C, Durand L, Pibarot P . Left ventricular longitudinal shortening in patients with aortic stenosis: relationship with symptomatic status. J Heart Valve Dis. 2003; 12(2):142-9. View

13.

Postolache A, Nguyen M, Julien T, Sperlongano S, Chitroceanu A, Dulgheru R . Exercise echocardiography in aortic stenosis with preserved ejection fraction. Anatol J Cardiol. 2020; 23(6):312-317. PMC: 7414241. DOI: 10.14744/AnatolJCardiol.2020.76500. View

14.

van Pelt N, Stewart R, Legget M, Whalley G, Wong S, Zeng I . Longitudinal left ventricular contractile dysfunction after exercise in aortic stenosis. Heart. 2006; 93(6):732-8. PMC: 1955170. DOI: 10.1136/hrt.2006.100164. View

15.

Goublaire C, Melissopoulou M, Lobo D, Kubota N, Verdonk C, Cimadevilla C . Prognostic Value of Exercise-Stress Echocardiography in Asymptomatic Patients With Aortic Valve Stenosis. JACC Cardiovasc Imaging. 2017; 11(6):787-795. DOI: 10.1016/j.jcmg.2017.03.020. View

16.

Genereux P, Stone G, OGara P, Marquis-Gravel G, Redfors B, Giustino G . Natural History, Diagnostic Approaches, and Therapeutic Strategies for Patients With Asymptomatic Severe Aortic Stenosis. J Am Coll Cardiol. 2016; 67(19):2263-2288. DOI: 10.1016/j.jacc.2016.02.057. View

17.

Lancellotti P, Lebois F, Simon M, Tombeux C, Chauvel C, Pierard L . Prognostic importance of quantitative exercise Doppler echocardiography in asymptomatic valvular aortic stenosis. Circulation. 2005; 112(9 Suppl):I377-82. DOI: 10.1161/CIRCULATIONAHA.104.523274. View

18.

Otto C, Nishimura R, Bonow R, Carabello B, Erwin 3rd J, Gentile F . 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2020; 77(4):e25-e197. DOI: 10.1016/j.jacc.2020.11.018. View

19.

Otto C, Prendergast B . Aortic-valve stenosis--from patients at risk to severe valve obstruction. N Engl J Med. 2014; 371(8):744-56. DOI: 10.1056/NEJMra1313875. View

20.

Lafitte S, Perlant M, Reant P, Serri K, Douard H, DeMaria A . Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis. Eur J Echocardiogr. 2008; 10(3):414-9. DOI: 10.1093/ejechocard/jen299. View