title: Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation.
abstract: Chronic aortic regurgitation (AR) is a valvulopathy of slow and insidious evolution, and patients may remain asymptomatic for a long period of time. Exercise-induced systolic dysfunction occurs during the natural history of chronic AR and is related to changes in both preload and afterload. We describe the case of a 58-year-old woman with a diagnosis of chronic AR who reported progressive dyspnea of six years' duration. A cardiopulmonary exercise test to assess functional capacity showed flattening of both oxygen uptake and oxygen pulse curves, suggesting latent systolic dysfunction related to chronic AR, which was later confirmed by stress Doppler echocardiogram with dynamic physical exercise.
authors.affiliation: Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. giovanidesanti@usp.br
authors.forename: Giovani Luiz
authors.initials: GL
authors.lastname: De Santi
authors.forename: Eduardo Elias Vieira
authors.initials: EE
authors.lastname: de Carvalho
authors.forename: Daniela Caetano
authors.initials: DC
authors.lastname: Costa
authors.forename: Júlio César
authors.initials: JC
authors.lastname: Crescencio
authors.forename: Minna Moreira
authors.initials: MM
authors.lastname: Dias Romano
authors.forename: André
authors.initials: A
authors.lastname: Schmidt
authors.forename: Marcus Vinícius
authors.initials: MV
authors.lastname: Simões
authors.forename: Lourenço
authors.initials: L
authors.lastname: Gallo
mesh_terms: D001022:Aortic Valve Insufficiency / Q000150:complications*; D002908:Chronic Disease; D005080:Exercise Test; D005260:Female; D006801:Humans; D008875:Middle Aged; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology*