Abstract 9488: Prognostic Value of Cardiopulmonary Exercise Testing in Patients With Asymptomatic or Equivocal Symptomatic Aortic Stenosis
| Autor: | Lars Kjøller-Hansen, Van D Le, Jensen G, Steen Carstensen |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
business.industry Cardiopulmonary exercise testing Stroke volume medicine.disease Asymptomatic Nyha class Aortic valve replacement Physiology (medical) Heart failure Internal medicine Cardiology Medicine In patient medicine.symptom Cardiology and Cardiovascular Medicine business Symptomatic aortic stenosis |
| Zdroj: | Circulation. 130 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circ.130.suppl_2.9488 |
| Popis: | Objective: To access the prognostic value of cardiopulmonary exercise testing (CPX) in patients with asymptomatic or equivocal symptomatic aortic stenosis (AS/ES-AS). Methods: Patients with AS/ES-AS without left ventricular dysfunction were prospectively grouped according to their CPX outcome: 1) peak oxygen-consumption (pVO 2 ) >83% and peak oxygen-pulse (pO 2 pulse) >95% of that predicted; 2) pVO 2 2 pulse 2 1 or clear exercise-limiting discomfort. At baseline Groups 1 (n=77) and 2 (n=35) were handled conservatively and Group 3 (n=18) referred for aortic valve replacement (AVR). Primary end-point was cardiac death, hospitalization with heart failure or AVR with improvement from just pre-AVR to nine months post-AVR in pVO 2 or Physical Component Score from the SF-36 > the estimated clinical relevant difference (5% and 7.5%, respectively). Results: The mean age, valve area and follow-up was 72.1±6.9 years, 0.45±0.11 cm/m 2 and 24±5 months, respectively; 48% were NYHA class ≥II. The end-point was reached in 25.3%, 26.4% and 62.5% in Group 1, 2 and 3, respectively (Group 3 vs. Group 1+2, p=0.007). One patient (0.7%) suffered cardiac death, eight months after recommendation of AVR, and 7 (6.3%) were hospitalized with heart failure. A pO 2 pulse Conclusions: CPX appears useful to separate those with a high probability of improvement with AVR from those, including patients with decreased pVO 2 , with a low event-rate with a conservative approach. |
| Databáze: | OpenAIRE |
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