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Original Research

Editor's Choice -- Free Access

Cardiopulmonary Exercise Testing in Patients with Asymptomatic or Equivocal Symptomatic Aortic Stenosis: Feasibility, Reproducibility, Safety and Information Obtained on Exercise Physiology

van Le D. · Jensen G.V.H. · Carstensen S. · Kjøller-Hansen L.

Author affiliations

Department of Cardiology, Roskilde University Hospital, Roskilde, Denmark

Corresponding Author

Lars Kjøller-Hansen

Department of Cardiology, Roskilde Hospital

Køgevej 7-13

DK-4000 Roskilde (Denmark)

E-Mail lak@regionsjaelland.dk

Related Articles for ""

Cardiology 2016;133:147-156

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Abstract

Objective: The aim of this study was to determine the feasibility, reproducibility, safety and information obtained on exercise physiology from cardiopulmonary exercise testing (CPX) in patients with aortic stenosis. Methods: Patients with an aortic valve area (AVA) <1.3 cm2 who were judged asymptomatic or equivocal symptomatic underwent CPX and an inert gas rebreathing test. Only those where comprehensive evaluation of CPX results indicated haemodynamic compromise from aortic stenosis were referred for valve replacement. Results: The mean patient age was 72 (±9) years; an AVA index <0.6 cm2/m2 and equivocal symptomatic status were found in 90 and 70%, respectively. CPX was feasible in 130 of the 131 patients. The coefficients of repeatability by test-retest were 5.4% (pVO2) and 4.6% (peak O2 pulse). A pVO2 <83% of the expected was predicted by a lower stroke volume at exercise, lower peak heart rate and FEV1, and higher VE/VCO2, but not by AVA index. Equivocal symptomatic status and a low gradient but high valvulo-arterial impedance were associated with a lower pVO2, but not with an inability to increase stroke volume. In total, 18 patients were referred for valve replacement. At 1 year, no cardiovascular deaths had occurred. Conclusions: CPX was feasible and reproducible and provided comprehensive data on exercise physiology. A CPX-guided treatment strategy was safe up to 1 year.

© 2015 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Research

Received: June 18, 2015
Accepted: September 24, 2015
Published online: November 20, 2015
Issue release date: February 2016

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 5

ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)

For additional information: http://www.karger.com/CRD


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