Does exercise echocardiography help assess functional repercussions and identify high-risk patients for early surgery in primary mitral regurgitation?
Exercise echocardiography is highlighted as an important tool for identifying high-risk patients with primary mitral regurgitation who may benefit from early surgical referral.
Primary mitral regurgitation is generally an insidious disease with late onset of symptoms. Current European and American guidelines recommend surgery in severe primary mitral regurgitation when symptoms, overt left ventricular dysfunction, pulmonary hypertension or atrial fibrillation, occur. However, recent large studies reported an improved outcome in asymptomatic patients with severe mitral regurgitation referred for early mitral valve repair despite the risk of operative mortality or mitral valve replacement. Moreover, primary mitral regurgitation appears to have an important dynamic character in up to one-third of patients. This article provides an overview of the incremental evidence of the ability of exercise echocardiography to assess the functional repercussions of mitral regurgitation and the identification of high-risk patients who might benefit from early referral for surgery.
Heyning et al. (Fri,) studied this question.
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