Correlation of Echocardiogram and Exercise Test Data in Children with Aortic Stenosis
| Autor: | Sherlly Xie, Tiancong Jiang, Rami Kharouf, Stephanie Santana, Samuel S. Gidding, Bradley W Robinson |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Aortic valve
medicine.medical_specialty Adolescent Heart disease medicine.medical_treatment 030204 cardiovascular system & hematology Chest pain Left ventricular hypertrophy 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans cardiovascular diseases Child Cardiac catheterization business.industry Aortic Valve Stenosis medicine.disease Cardiac surgery Stenosis medicine.anatomical_structure Blood pressure 030228 respiratory system Echocardiography Pediatrics Perinatology and Child Health Exercise Test Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
| Zdroj: | Pediatric Cardiology. 40:1516-1522 |
| ISSN: | 1432-1971 0172-0643 |
| DOI: | 10.1007/s00246-019-02177-1 |
| Popis: | Previous pediatric exercise test criteria for aortic stenosis severity were based on cardiac catheterization assessment, whereas current criteria are based on echocardiographic valve gradients. We sought to correlate exercise test criteria with echocardiographic assessment of severity. We report 65 studies, 51 patients (mean age of 13 ± 4 years; 75% males), with aortic stenosis (AS) who had a maximal exercise test between 2005 and 2016. We defined three groups based on resting mean Doppler gradient across their aortic valve: severe AS (n = 10; gradient of ≥ 40 mmHg), moderate AS (n = 20; gradient 25-39 mmHg), and mild AS (n = 35; gradient ≤ 24 mmHg). We studied symptoms (chest pain) during exercise, resting electrocardiogram changes (left ventricular hypertrophy [LVH]), complex arrhythmias during exercise, change in exercise systolic blood pressure (SBP; delta SBP = peak SBP-resting SBP), exercise duration, work, echocardiogram parameters (LVH), and ST-T wave changes with exercise. Additionally, we compared work and delta SBP during exercise with 117 control males and females without heart disease. Severe AS patients have statistically significant differences when compared with mild AS in ST-T wave depression during exercise, LVH on resting electrocardiogram, and echocardiogram. There was a significant difference in delta SBP between severe AS and normal controls (delta SBP 21.6 vs. 46.2 mmHg), and between moderate AS and normal controls (delta SBP 32 vs. 46.2 mmHg). There were no significant complications during maximal exercise testing. Children with echocardiographic severe and moderate AS have exercise testing abnormalities. Exercise test criteria for severity of AS were validated for echocardiographic criteria for AS severity. |
| Databáze: | OpenAIRE |
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