How does supine exercise affect left ventricular haemodynamics in children with isolated aortic valvular disease?
Children with isolated aortic valvular disease generally maintain a normal haemodynamic response to exercise, characterized by an appropriate increase in cardiac output without excessive elevation in left ventricular filling pressures.
Left ventricular haemodynamics were studied both at rest and during supine exercise in 33 children with isolated aortic valvular disease, either aortic stenosis or aortic insufficiency. In each child cardiac index and stroke index were normal at rest. Exercise response was characterized in 32 patients by an increase in cardiac index without a major increase in left ventricular end-diastolic pressure. Only one patient showed an abnormal exercise response. In each patient with aortic stenosis an increase in peak left ventricular systolic pressure occurred on exercise, while no predictable change occurred among patients with aortic insufficiency. Left ven- tricular end-diastolic pressure was greater in patients with more severe stenosis or with significant aortic insufficiency.
Cueto et al. (Mon,) studied this question.
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