title: Value of echo-Doppler derived pulmonary vascular resistance, net-atrioventricular compliance and tricuspid annular velocity in determining exercise capacity in patients with mitral stenosis.
abstract: 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.
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Jaemin
authors.initials: J
authors.lastname: Shim
authors.forename: Sung-Ai
authors.initials: SA
authors.lastname: Kim
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Se-Jung
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: 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*