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

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.

journal_name

Cardiology

journal_title

Cardiology

authors

van Le D,Jensen GV,Carstensen S,Kjøller-Hansen L

doi

10.1159/000441292

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

147-56

issue

3

eissn

0008-6312

issn

1421-9751

pii

000441292

journal_volume

133

pub_type

杂志文章
  • Trans-Fatty Acids and Cardiovascular Disease: Urgent Need for Legislation.

    abstract::Hydrogenated oils containing trans-fatty acids (TFA) are used to produce margarine and various processed foods. TFA affect serum lipid levels, fatty acid metabolism, and endothelial function. High TFA intake is linked to increased all-cause mortality, coronary heart disease mortality, and cardiovascular disease (CVD) ...

    journal_title:Cardiology

    pub_type: 杂志文章,评审

    doi:10.1159/000479956

    authors: Wilczek MM,Olszewski R,Krupienicz A

    更新日期:2017-01-01 00:00:00

  • Importance of coronary collateral circulation for increased treadmill exercise capacity by nitrates in patients with stable effort angina pectoris.

    abstract::The purpose of this study was to elucidate the mechanism that induces an improvement in exercise capacity by nitrates in patients with stable effort angina pectoris. The study population was composed of 19 patients: group A, 10 patients with chronic stable effort angina who had a well-developed coronary collateral cir...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000174812

    authors: Ohno A,Fujita M,Miwa K,Ejiri M,Asanoi H,Sasayama S

    更新日期:1991-01-01 00:00:00

  • Prognosis of a normal positron emission tomography 82Rb myocardial perfusion imaging study in women with no history of coronary disease.

    abstract:OBJECTIVES:Myocardial perfusion imaging (MPI) with positron emission tomography (PET) has advantages over single-photon emission computerized tomography, particularly for women. This investigation was undertaken to define the prognosis of a normal stress PET MPI study in women. METHODS:The cohort comprised 457 women e...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000323841

    authors: Van Tosh A,Supino PG,Nichols KJ,Garza D,Horowitz SF,Reichek N

    更新日期:2010-01-01 00:00:00

  • Asymptomatic Pulmonary Embolism after Ablation.

    abstract:BACKGROUND:Pulmonary embolism (PE) is a life-threatening event with a broad presentation spectrum ranging from asymptomatic cases to sudden cardiac arrest. It is unclear if right atrial emboli cause PE in patients with atrial fibrillation (AF) or if mild PE itself increases right cardiac pressure provoking AF. OBJECTI...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000444440

    authors: Guler GB,Can MM,Guler E,Akinci T,Sogukpinar O,Hatipoglu S,Kilicaslan F,Serebruany VL

    更新日期:2016-01-01 00:00:00

  • Nitrate therapy in heart failure.

    abstract::Nitrates are drugs of first choice in patients with acute heart failure. Acute pulmonary edema can be successfully treated with single or repeated doses of sublingual nitroglycerin. In cases of prolonged acute heart failure, e.g. in the setting of acute myocardial infarction, nitroglycerin or isosorbide dinitrate can ...

    journal_title:Cardiology

    pub_type: 杂志文章,评审

    doi:10.1159/000174917

    authors: Schneider W,Bussmann WD,Hartmann A,Kaltenbach M

    更新日期:1991-01-01 00:00:00

  • The Dual Antiplatelet Therapy Trial after the FDA Update: Noncardiovascular Deaths, Cancer and Optimal Treatment Duration.

    abstract:BACKGROUND:The landmark Dual Antiplatelet Therapy (DAPT) trial revealed an impressive reduction of stent thrombosis and myocardial infarction after prolonged 30-month DAPT compared to the conventional 12-month regimen. However, aside from the expected extra bleeding risks, more cancers and noncardiovascular deaths (NCV...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000431356

    authors: Serebruany VL,Cherepanov V,Golukhova EZ,Kim MH

    更新日期:2015-01-01 00:00:00

  • Atrial fibrillation and antithrombotic therapy in a 75-year-old population.

    abstract:AIMS:To find the true prevalence of diagnosed and undiagnosed atrial fibrillation (AF) in a population aged 75 years in 2 municipalities in Norway, and to study the use of antithrombotic therapy in this group. METHODS:All 1,117 citizens in Asker and Baerum municipalities in eastern Norway born in 1930 were invited to ...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000107789

    authors: Tveit A,Abdelnoor M,Enger S,Smith P

    更新日期:2008-01-01 00:00:00

  • Exercise capacity in patients with left ventricular dysfunction following acute myocardial infarction: relation to systolic and diastolic function and intervention with captopril.

    abstract::Patients with acute or chronic heart disease may have limited exercise capacity if they have reduced left ventricular function. Indexes of reduced left ventricular function during exercise are a predictor of subsequent survival although left ventricular ejection fraction is a poor predictor of physical endurance. We e...

    journal_title:Cardiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1159/000176419

    authors: Søgaard P,Gøtzsche CO,Ravkilde J,Nørgaard A,Thygesen K

    更新日期:1994-01-01 00:00:00

  • Pulse pressure and left ventricular diastolic dysfunction in hypertensive patients.

    abstract:BACKGROUND:Impaired left ventricular diastolic function is a common finding in essential hypertension. METHODS:In order to investigate possible relationships between flow velocity through the mitral valve (E/A; index of left ventricular diastolic function) and 24-hour blood pressure and heart rate variations, 198 pati...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000078149

    authors: Trika CO,Zakopoulos N,Toumanidis ST,Stamatelopoulos SF,Moulopoulos SD

    更新日期:2004-01-01 00:00:00

  • Prediction of left ventricular functional recovery by dobutamine echocardiography, F-18 deoxyglucose or 99mTc sestamibi nuclear imaging in patients with chronic myocardial infarction.

    abstract:BACKGROUND:Currently, several modalities are available to predict viability, however, studies comparing various modalities validated by functional recovery after revascularization are scarce. This study analyzed the relative merits of low-dose dobutamine echocardiography, F-18 deoxyglucose (FDG) positron emission tomog...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000067311

    authors: Lund GK,Freyhoff J,Schwaiger M,Lübeck M,Lund CH,Buchert R,Sheehan FH,Meinertz T,Nienaber CA

    更新日期:2002-01-01 00:00:00

  • Effect of single oral dose of aspirin on human platelet functions and plasma plasminogen activator inhibitor-1.

    abstract::Previous reports documented the inhibitory efficacy of different doses of aspirin on arachidonic acid (AA)-induced platelet aggregation, however, the sensitivity of platelets toward other agonists as well as the effects of aspirin on platelet and plasma plasminogen activator inhibitor-1 (PAI-1) release and levels were...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000175993

    authors: Mousa SA,Forsythe MS,Bozarth JM,Reilly TM

    更新日期:1993-01-01 00:00:00

  • Expression of Plasma microRNA-1/21/ 208a/499 in myocardial ischemic reperfusion injury.

    abstract:OBJECTIVES:We aimed to measure changes in the levels of several miRNAs during open-heart surgery and to investigate the relationship between these changes and cardiac biomarkers. METHODS:Creatine kinase-muscle band (CK-MB), cardiac troponin (cTnI) and miRNA (miR-1/21/208a/499) levels were measured during open-heart su...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000371792

    authors: Yang W,Shao J,Bai X,Zhang G

    更新日期:2015-01-01 00:00:00

  • The Phenotype and Outcome of Infantile Cardiomyopathy Caused by a Homozygous ELAC2 Mutation.

    abstract:OBJECTIVE:Cardiomyopathy (CMP) in children is a clinically and genetically heterogeneous group of disorders. Disease-associated mutations have been identified in more than 50 genes. Recently, mutations in the mitochondrial tRNA processing gene, ELAC2, were reported to be associated with the recessively inherited form o...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000465516

    authors: Shinwari ZMA,Almesned A,Alakhfash A,Al-Rashdan AM,Faqeih E,Al-Humaidi Z,Alomrani A,Alghamdi M,Colak D,Alwadai A,Rababh M,Al-Fayyadh M,Al-Hassnan ZN

    更新日期:2017-01-01 00:00:00

  • Valvular heart disease by transthoracic echocardiography is associated with focal brain injury and central neuropsychiatric systemic lupus erythematosus.

    abstract:BACKGROUND:Previous studies using transesophageal echocardiography (TEE) report an association of valvular heart disease (VHD) with cerebral infarcts and central neuropsychiatric systemic lupus erythematosus (NPSLE). However, TEE cannot be routinely used. AIM:To determine if VHD detected by transthoracic echocardiogra...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000099104

    authors: Roldan CA,Gelgand EA,Qualls CR,Sibbitt WL Jr

    更新日期:2007-01-01 00:00:00

  • ACP1 genetic polymorphism and coronary artery disease: an association study.

    abstract:OBJECTIVES:Assuming an immune component in the pathogenesis of atherosclerosis, we have investigated a possible association between coronary artery disease (CAD) and the acid phosphatase locus 1 (ACP1) genetic polymorphism, which has previously been found to be associated with immune disorders. METHODS:226 subjects ad...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000203405

    authors: Banci M,Saccucci P,D'Annibale F,Dofcaci A,Trionfera G,Magrini A,Bottini N,Bottini E,Gloria-Bottini F

    更新日期:2009-01-01 00:00:00

  • Long-term prognostic value of creatine kinase-myocardial band mass after cardiac surgery in low-risk patients with stable angina.

    abstract:OBJECTIVES:The long-term prognostic value (>5 years) of elevated cardiac biomarkers after elective cardiac surgery is not clear. Most previous studies have included high-risk, unstable patients. The aim of this study was to determine the prognostic value of creatine kinase-myocardial band (CK-MB) mass after elective ca...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000177949

    authors: Vikenes K,Andersen KS,Melberg T,Farstad M,Nordrehaug JE

    更新日期:2009-01-01 00:00:00

  • Cardioprotective potential of carvedilol.

    abstract::Carvedilol is a multiple-action cardiovascular agent that is a nonselective beta-adrenoceptor antagonist and a vasodilator. beta-Adrenoceptor antagonists reduce myocardial work, secondary to reductions in heart rate and contractility, both in animals and in humans. For these reasons, carvedilol may improve survival of...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000175930

    authors: Ruffolo RR Jr,Bril A,Feuerstein GZ

    更新日期:1993-01-01 00:00:00

  • A case of pulmonary alveolar microlithiasis with cardiac constriction secondary to severe adjacent pleural involvement.

    abstract::Pulmonary alveolar microlithiasis (PAM) is a rare disorder of uncertain etiology and pathogenesis that is characterized by tiny calcium phosphate depositions in lung alveoli. Ectopic organ involvement has been reported infrequently. We hereby present a patient with PAM complicated by severe pleural calcification that ...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000095420

    authors: Kacmaz F,Alyan O,Celenk M,Ozdemir O,Turkvatan A,Dogan M,Ilkay E

    更新日期:2007-01-01 00:00:00

  • Physical rehabilitation in coronary patients who have suffered from episodes of cardiac failure.

    abstract::The effects of bicycle training for 5 weeks were evaluated in 12 patients after myocardial infarction with left ventricular dysfunction (left ventricular ejection fraction < 40%) and at least one episode of cardiac failure in the past. The patients were divided into two groups of six according to the Weber classificat...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000175034

    authors: Scalvini S,Marangoni S,Volterrani M,Schena M,Quadri A,Levi GF

    更新日期:1992-01-01 00:00:00

  • Viable but denervated right ventricular myocardium: a case of Eisenmenger reaction.

    abstract::We report on a 47-year-old woman who experienced an Eisenmenger reaction (mean pulmonary artery pressure: 86 mm Hg) induced by atrial septal defect. Radionuclide myocardial scans with 99mTc-MIBI and 123I-BMIPP showed increased uptake to the right ventricular myocardium, whereas the 123I-MIBG scan disclosed no uptake t...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000177435

    authors: Hirose Y,Ishida Y,Hayashida K,Satoh T,Shimotsu Y,Nishimura T

    更新日期:1997-11-01 00:00:00

  • Effect of right atrial stimulation on both atrial pressure and atrial natriuretic peptide release in essential hypertension.

    abstract:UNLABELLED:Several reports indicated a direct relationship between atrial pacing and atrial natriuretic peptide (ANP) blood levels, but few controlled hemodynamic studies have been reported. In particular, the relationship between increase in heart rate, release of ANP and increase in right atrial pressure (RAP) are st...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000174809

    authors: Michelucci A,Padeletti L,Monopoli A,Fabbri G,Tostiguerra C,Giovannini T,Franchi F

    更新日期:1991-01-01 00:00:00

  • Rare association of congenital bicuspid aortic valve, annuloaortic ectasia, and anomalous origin of left circumflex coronary artery.

    abstract::A bicuspid aortic valve (BAV) is one of the most common congenital heart anomalies. Although each annuloaortic ectasia (AAE) and malformation of the left coronary artery has been described as a complication of BAV, no case associated with both abnormalities has been reported previously. We present here a very rare cas...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000176329

    authors: Takahashi M,Ikeda U,Shimada K,Takeda H

    更新日期:1994-01-01 00:00:00

  • Wandering atrial pacemaker associated with repetitive respiratory strain.

    abstract::Electrocardiographic responses of body-builders and control subjects obtained during the performance of static and dynamic Valsalva maneuvers were studied to determine the causative stimulus for wandering pacemaker activity. The incidence of shifting or wandering pacemaker was nearly double in body-builders, suggestin...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000173486

    authors: Borgia JF,Nizet PM,Gliner JA,Horvath SM

    更新日期:1982-01-01 00:00:00

  • Serial magnetic resonance imaging of global and regional left ventricular remodeling during 1 year after acute myocardial infarction.

    abstract::Biplane long-axis cine MRI was performed in 51 patients 1, 13, 26, and 52 weeks after their first AMI. LV mass index (LVMI) was significantly increased 1 week after AMI (84.3 +/- 16.9 vs. 68.1 +/- 11.4 g/m(2) controls, n = 48, p < 0.001), presumably owing to edema of the infarcted myocardium. Six months after AMI, LVM...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000049092

    authors: Schroeder AP,Houlind K,Pedersen EM,Nielsen TT,Egeblad H

    更新日期:2001-01-01 00:00:00

  • Oral anticoagulation in nonvalvular atrial fibrillation in clinical practice: impact of CHADS(2) score on outcome.

    abstract:OBJECTIVES:CHADS(2) score predicts embolic risk in patients with nonvalvular atrial fibrillation (NVAF), but also bleeding risk in patients receiving oral anticoagulation (OAC). Our objective is to analyze the effectiveness and safety of OAC in patients with NVAF in daily clinical practice, according to embolic risk ev...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000284450

    authors: Ruiz Ortiz M,Romo E,Mesa D,Delgado M,Anguita M,Castillo JC,Arizón JM,Suárez de Lezo J

    更新日期:2010-01-01 00:00:00

  • Cardiovascular changes in awake dogs caused by suddenly induced aortic hypertension.

    abstract::Cardiovascular adaptation to the sudden inflation of a balloon in the descending aorta was investigated in intact awake, standing dogs. The balloon inflation raised pressure in the arterial bed proximal from the balloon. Initially, it lowered heart rate and cardiac output. After 4 sec, heart rate and cardiac output be...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000169905

    authors: Ehrlich W,Rodriguez-Lopez E

    更新日期:1978-01-01 00:00:00

  • Glycosylated Hemoglobin as a Surrogate for the Prevention of Cardiovascular Events in Cardiovascular Outcome Trials Comparing New Antidiabetic Drugs to Placebo.

    abstract:BACKGROUND AND OBJECTIVES:The value of glycosylated hemoglobin (HbA1c) as a surrogate marker for the prevention of cardiovascular outcomes on antidiabetic drugs is debated. The 2008 FDA guidance led to multiple large clinical trials to evaluate the effect of new antidiabetic drugs versus placebo on major adverse cardia...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000506004

    authors: Ambrosi P,Daumas A,Villani P,Giorgi R

    更新日期:2020-01-01 00:00:00

  • Serum chitotriosidase activity, a marker of activated macrophages, predicts new cardiovascular events independently of C-reactive protein.

    abstract:BACKGROUND:C-reactive protein (CRP) is a well-established inflammation marker associated with cardiovascular risk. However, its relationship with chitotriosidase activity, a novel marker of activated macrophages highly expressed in human atherosclerotic plaques, is unknown. Therefore, we sought to determine if serum ch...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000099099

    authors: Artieda M,Cenarro A,Gañán A,Lukic A,Moreno E,Puzo J,Pocoví M,Civeira F

    更新日期:2007-01-01 00:00:00

  • Detection of circulating alpha-actinin in non-insulin-dependent diabetics with autonomic dysfunction.

    abstract::The presence of cardiac proteins in serum has been related to ischemic heart diseases such as acute myocardial infarction and angina pectoris, which are more frequent in non-insulin-dependent diabetic patients. Silent myocardial ischemia, which is also more frequent in these patients, occurs in association with autono...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000177106

    authors: Prados J,Melguizo C,Arånega AE,Escobar-Jimenez F,Cobo V,Aránega A

    更新日期:1996-07-01 00:00:00

  • Aortic stiffness is an independent predictor of left ventricular function in patients with coronary heart disease.

    abstract::Although aortic stiffness plays an important role in patients with coronary artery disease (CAD), the influence of aortic stiffness on left ventricular systolic function has not yet been fully evaluated. In the present study, we measured brachial-ankle pulse wave velocity (baPWV), which is a new index of aortic stiffn...

    journal_title:Cardiology

    pub_type: 杂志文章

    doi:10.1159/000082472

    authors: Sakuragi S,Iwasaki J,Tokunaga N,Hiramatsu S,Ohe T

    更新日期:2005-01-01 00:00:00