Does quantitative exercise Doppler echocardiography predict cardiac events in patients with severe asymptomatic aortic stenosis?
Quantitative Doppler exercise echocardiography provides incremental prognostic value over resting parameters to identify high-risk patients with asymptomatic severe aortic stenosis.
BACKGROUND: In patients with asymptomatic valvular aortic stenosis, exercise testing may help to stratify the clinical risk. However, data are limited, and the role of quantitative exercise Doppler echocardiography has never been investigated. METHODS AND RESULTS: Sixty-nine consecutive patients with severe asymptomatic aortic stenosis (aortic valve area or =1 of the following findings: angina, dyspnea, > or =2 mm ST segment depression, or fall or small ( or =18 mm Hg during exercise (P=0.0015), an abnormal exercise test (P=0.0026), and an aortic valve area <0.75 cm2 (P=0.0031). Exercise Doppler echocardiographic findings provided incremental prognostic value over resting echocardiographic and exercise electrocardiographic parameters. CONCLUSIONS: Quantitative Doppler exercise echocardiography could be useful to identify a high-risk subset of patients with asymptomatic valvular aortic stenosis and help for clinical decision making.
Lancellotti et al. (2005) studied this question.