[Value of resting and exercise mitral regurgitation during exercise echocardiography to predict outcome in patients with left ventricular dysfunction].
OBJECTIVE
The relative value of exercise echocardiography (EE) over resting echocardiography when this last incorporates information on mitral regurgitation (MR) is unknown. Furthermore, limited data exists regarding to the value of MR worsening during exercise in patients with LV dysfunction. We investigated whether: a) EE has incremental value over a resting echo-Doppler study; and b) post-exercise MR increments the value of EE for predicting outcome in patients with LV dysfunction.


METHODS
388 consecutive patients with LV dysfunction (LV ejection fraction <50%) were followed for 2.1 (1.5) years. There were 46 hard events (myocardial infarction in 10 and cardiac death in 36).


RESULTS
There were 43 events in 319 patients with abnormal EE vs 3 events in 69 patients with normal EE (13% vs 4%, P=.04), whereas there were 20 events in the 103 patients with at least moderate resting MR vs 26 events in the 288 with no/mild MR (19% vs 9%, P=.006). Resting MR, peak heart rate x blood pressure, and n masculine of diseased territories on EE were independently associated to hard events. The same variables and MR worsening were independently associated to cardiac death.


CONCLUSIONS
EE maintains its higher prognostic value over resting echocardiography even when this last incorporates information on MR. MR worsening increments the value of EE for predicting cardiac death in patients with LV dysfunction.
Peteiro
Jesús
J
Unidad de Ecocardiografía, Hospital Juan Canalejo, Universidad de A Coruña, A Coruña, Spain. pete@canalejo.org
Monserrat
Lorenzo
L
Piñón
Pablo
P
Bouzas
Alberto
A
Campos
Rosa
R
Mosquera
Ignacio
I
Mariñas
Javier
J
Bouzas
Beatriz
B
Castro-Beiras
Alfonso
A
D015150:Echocardiography, Doppler; D025401:Echocardiography, Stress; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012146:Rest; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*