Exercise behavior of degenerative mitral stenosis.
Aged
Bicycling
Calcinosis
/ complications
Case-Control Studies
Dyspnea
/ etiology
Echocardiography, Doppler
Echocardiography, Stress
Exercise Test
Exercise Tolerance
Female
Hemodynamics
Humans
Male
Middle Aged
Mitral Valve
/ diagnostic imaging
Mitral Valve Stenosis
/ complications
Predictive Value of Tests
Reproducibility of Results
Time Factors
Exercise
Mitral annular calcification
Mitral valve gradient
Pulmonary pressure
Journal
The international journal of cardiovascular imaging
ISSN: 1875-8312
Titre abrégé: Int J Cardiovasc Imaging
Pays: United States
ID NLM: 100969716
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
26
03
2020
accepted:
21
05
2020
pubmed:
28
5
2020
medline:
29
9
2020
entrez:
28
5
2020
Statut:
ppublish
Résumé
Mitral annular calcification (MAC) is increasingly encountered, particularly among the elderly and those with chronic kidney disease, and is often associated with a transvalvular gradient. In contrast to rheumatic mitral stenosis relatively little is known about mitral stenosis due to MAC. We aimed to clarify whether exercise limitation in this group is primarily due to valvular obstruction or ventricular dysfunction resulting from multiple comorbidities. 20 patients with severe MAC (bulky calcium deposits which restricted leaflet motion) were submitted to supine bicycle exercise, measuring Doppler and echocardiographic parameters at baseline and during exercise. They were compared 1:1 to subjects matched for age, sex, and left ventricular wall thickness. At baseline MAC subjects had higher mean mitral valve gradients (MVG) than comparison subjects (7.5 ± 3.8 vs 1.6 ± 0.8 mm Hg, p < 0.0001), along with larger indexed left atrial volumes (54.4 ± 14.9 vs 34.0 ± 11.7 mL, p < 0.0001) and reduced left atrial strains (reservoir, conduit, and booster pump). With exercise MAC subjects reached higher levels of MVG (17.3 ± 8.4 vs 5.5 ± 2.5 mm Hg, p < 0.0001), and pulmonary artery systolic pressure (estimated from tricuspid regurgitant jet [TR] velocity) and displayed a moderate correlation between ΔMVG and ΔTR velocity (r
Identifiants
pubmed: 32458290
doi: 10.1007/s10554-020-01898-2
pii: 10.1007/s10554-020-01898-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1845-1853Subventions
Organisme : Albert Einstein Society
ID : 15-17
Références
Faggiano P, Dasseni N, Gaibazzi N, Rossi A, Henein M, Pressman G (2019) Cardiac calcification as a marker of subclinical atherosclerosis and predictor of cardiovascular events: a review of the evidence. Eur J Prev Cardiol 26(11):1191–1204. https://doi.org/10.1177/2047487319830485
doi: 10.1177/2047487319830485
pubmed: 30845832
Muddassir SM, Pressman GS (2007) Mitral annular calcification as a cause of mitral valve gradients. Int J Cardiol 123(1):58–62. https://doi.org/10.1016/j.ijcard.2006.11.142
doi: 10.1016/j.ijcard.2006.11.142
pubmed: 17320214
Chu JW, Levine RA, Chua S, Poh KK, Morris E, Hua L, Ton-Nu TT, Hung J (2008) Assessing mitral valve area and orifice geometry in calcific mitral stenosis: a new solution by real-time three-dimensional echocardiography. J Am Soc Echocardiogr 21(9):1006–1009. https://doi.org/10.1016/j.echo.2008.05.010
doi: 10.1016/j.echo.2008.05.010
pubmed: 18620839
pmcid: 2980787
Nishimura RA, Rihal CS, Tajik AJ, Holmes DR Jr (1994) Accurate measurement of the transmitral gradient in patients with mitral stenosis: a simultaneous catheterization and Doppler echocardiographic study. J Am Coll Cardiol 24(1):152–158. https://doi.org/10.1016/0735-1097(94)90556-8
doi: 10.1016/0735-1097(94)90556-8
pubmed: 8006259
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1–39. https://doi.org/10.1016/j.echo.2014.10.003
doi: 10.1016/j.echo.2014.10.003
Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, Calverley PM, Gift AG, Harver A, Lareau SC, Mahler DA, Meek PM, O'Donnell DE, American Thoracic Society Committee on D (2012) An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med 185(4):435–452. https://doi.org/10.1164/rccm.201111-2042ST
doi: 10.1164/rccm.201111-2042ST
Lancellotti P, Dulgheru R, Go YY, Sugimoto T, Marchetta S, Oury C, Garbi M (2018) Stress echocardiography in patients with native valvular heart disease. Heart 104(10):807–813. https://doi.org/10.1136/heartjnl-2017-311682
doi: 10.1136/heartjnl-2017-311682
pubmed: 29217633
Demirkol S, Kucuk U, Baysan O, Balta S, Celik T, Kurt IH, Kucuk HO, Yuksel UC, Unlu M, Yokusoglu M (2012) The impact of mitral stenosis on left atrial function assessed by two-dimensional speckle tracking echocardiography. Echocardiography 29(9):1064–1070. https://doi.org/10.1111/j.1540-8175.2012.01751.x
doi: 10.1111/j.1540-8175.2012.01751.x
pubmed: 22672328
Buggey J, Hoit BD (2018) Left atrial strain: measurement and clinical application. Curr Opin Cardiol 33(5):479–485. https://doi.org/10.1097/HCO.0000000000000537
doi: 10.1097/HCO.0000000000000537
pubmed: 29912019
Ancona R, Comenale Pinto S, Caso P, Di Salvo G, Severino S, D'Andrea A, Calabro R (2013) Two-dimensional atrial systolic strain imaging predicts atrial fibrillation at 4-year follow-up in asymptomatic rheumatic mitral stenosis. J Am Soc Echocardiogr 26(3):270–277. https://doi.org/10.1016/j.echo.2012.11.016
doi: 10.1016/j.echo.2012.11.016
pubmed: 23261148
O'Neal WT, Efird JT, Nazarian S, Alonso A, Michos ED, Szklo M, Heckbert SR, Soliman EZ (2018) Mitral annular calcification progression and the risk of atrial fibrillation: results from MESA. Eur Heart J Cardiovasc Imaging 19(3):279–284. https://doi.org/10.1093/ehjci/jex093
doi: 10.1093/ehjci/jex093
pubmed: 28460029
Laufer-Perl M, Gura Y, Shimiaie J, Sherez J, Pressman GS, Aviram G, Maltais S, Megidish R, Halkin A, Ingbir M, Biner S, Keren G, Topilsky Y (2017) Mechanisms of effort intolerance in patients with rheumatic mitral stenosis: combined echocardiography and cardiopulmonary stress protocol. JACC Cardiovasc Imaging 10(6):622–633. https://doi.org/10.1016/j.jcmg.2016.07.011
doi: 10.1016/j.jcmg.2016.07.011
pubmed: 27865723
Nair CK, Sketch MH, Desai R, Mohiuddin SM, Runco V (1982) High prevalence of symptomatic bradyarrhythmias due to atrioventricular node-fascicular and sinus node-atrial disease in patients with mitral anular calcification. Am Heart J 103(2):226–229. https://doi.org/10.1016/0002-8703(82)90496-3
doi: 10.1016/0002-8703(82)90496-3
pubmed: 7055056
Moukabary T, Faletra FF, Kronzon I, Thomas W, Sorrell VL (2012) Three-dimensional echocardiography in the electrophysiology laboratory. Echocardiography 29(1):117–122. https://doi.org/10.1111/j.1540-8175.2011.01613.x
doi: 10.1111/j.1540-8175.2011.01613.x
pubmed: 23186296
John RM, Kumar S (2016) Sinus node and atrial arrhythmias. Circulation 133(19):1892–1900. https://doi.org/10.1161/CIRCULATIONAHA.116.018011
doi: 10.1161/CIRCULATIONAHA.116.018011
pubmed: 27166347
Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, Coke LA, Fleg JL, Forman DE, Gerber TC, Gulati M, Madan K, Rhodes J, Thompson PD, Williams MA, American Heart Association Exercise CR, Prevention Committee of the Council on Clinical Cardiology CoNPA, Metabolism CoC, Stroke N, Council on E, Prevention (2013) Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 128(8):873–934. https://doi.org/10.1161/CIR.0b013e31829b5b44
doi: 10.1161/CIR.0b013e31829b5b44