Value of echo-Doppler derived pulmonary vascular resistance, net-atrioventricular compliance and tricuspid annular velocity in determining exercise capacity in patients with mitral stenosis.
BACKGROUND
The present study sought to determine if echo-Doppler-derived pulmonary vascular resistance (PVR echo), net-atrioventricular compliance (Cn) and tricuspid peak systolic annular velocity (Sa), as parameters of right ventricular function, have value in predicting exercise capacity in patients with mitral stenosis (MS).


RESULTS
Thirty-two patients with moderate or severe MS without left ventricular systolic dysfunction were studied. After comprehensive echo-Doppler measurements, including PVR echo, tricuspid Sa and left-sided Cn, supine bicycle exercise echo and concomitant respiratory gas analysis were performed. Measurements during 5 cardiac cycles representing the mean heart rate were averaged. Increment of resting PVR(echo) (r=-0.416, p=0.018) and decrement of resting Sa (r=0.433, p=0.013) and Cn (r=0.469, p=0.007) were significantly associated with decrease in %VO(2) peak. The predictive accuracy for %VO2 peak could increase by combining these parameters as Sa/PVR echo (r=0.500, p=0.004) or Cn. (Sa/PVR echo) (r=0.572, p=0.001) independent of mitral valve area, mean diastolic pressure gradients or presence of atrial fibrillation.


CONCLUSIONS
Measurement of PVR echo, Cn and Sa might provide important information about the exercise capacity of patients with MS.
Choi
Eui-Young
EY
Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Shim
Jaemin
J
Kim
Sung-Ai
SA
Shim
Chi Young
CY
Yoon
Se-Jung
SJ
Kang
Seok-Min
SM
Choi
Donghoon
D
Ha
Jong-Won
JW
Rim
Se-Joong
SJ
Jang
Yangsoo
Y
Chung
Namsik
N
D000328:Adult; D001283:Atrioventricular Node / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology; D015150:Echocardiography, Doppler; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008170:Lung Compliance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000503:physiopathology*; D014261:Tricuspid Valve / Q000502:physiology*; D014655:Vascular Resistance / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*