Key result
Exercise echocardiography provided additional clinical value by altering or confirming the treatment strategy in 71% of patients with disproportionately symptomatic or atypical mitral valve disease.
Why the study?
Does exercise echocardiography improve clinical decision-making in patients with mitral valve disease?
Observational (n=28)
No
Does exercise echocardiography improve clinical decision-making in patients with mitral valve disease?
Exercise echocardiography provides significant additional value in clinical decision-making for challenging patients with mitral valve disease by altering or confirming treatment strategies in 71% of cases.
Supports exercise echocardiography for decision-making in select mitral valve disease; hypothesis-generating and requires randomized confirmation before practice change.
PURPOSE: Exercise echocardiography can assess the dynamic component of mitral valve (MV) disease and may therefore be helpful for the clinical decision-making by the heart team. The purpose of this study is to determine the role of exercise echocardiography in the management of disproportionately symptomatic or otherwise atypical patients with mitral regurgitation (MR) and stenosis (MS) in clinical practice. METHODS: Data of 14 MR and 14 MS patients, including echocardiograms at rest, were presented retrospectively to an experienced heart team to determine treatment strategy. Subsequently, exercise echo data were provided whereupon once again the treatment strategy was determined. This resulted in: value of exercise echo by means of 1) alteration or 2) confirmation of treatment strategy or 3) no additional value. RESULTS: During exercise the echocardiographic severity of MV disease increased in 9 (64 %) MR and 8 (57 %) MS patients. Based upon alteration or confirmation of the treatment strategy, the value of exercise echocardiography in the management of MR and MS was 86 % and 57 %, respectively. CONCLUSION: This study showed that physical exercise echo can have an important role in the clinical decision-making of challenging patients with MV disease. Exercise echocardiography had additional value to the treatment strategy in 71 % of these patients.
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Jansen et al. (2013) conducted an observational in Mitral valve disease (mitral regurgitation and mitral stenosis) (n=28). Exercise echocardiography vs. Resting echocardiography alone was evaluated on Additional value of exercise echocardiography (alteration or confirmation of treatment strategy). Exercise echocardiography provided additional clinical value by altering or confirming the treatment strategy in 71% of patients with disproportionately symptomatic or atypical mitral valve disease.
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