title: The role of exercise echocardiography in the management of mitral valve disease.
abstract: OBJECTIVE
  Exercise echocardiography can assess the dynamic component of mitral valve (MV) disease and may therefore be helpful for the clinical decision-making by the heart team. The purpose of this study is to determine the role of exercise echocardiography in the management of disproportionately symptomatic or otherwise atypical patients with mitral regurgitation (MR) and stenosis (MS) in clinical practice.
  
  
  METHODS
  Data of 14 MR and 14 MS patients, including echocardiograms at rest, were presented retrospectively to an experienced heart team to determine treatment strategy. Subsequently, exercise echo data were provided whereupon once again the treatment strategy was determined. This resulted in: value of exercise echo by means of 1) alteration or 2) confirmation of treatment strategy or 3) no additional value.
  
  
  RESULTS
  During exercise the echocardiographic severity of MV disease increased in 9 (64 %) MR and 8 (57 %) MS patients. Based upon alteration or confirmation of the treatment strategy, the value of exercise echocardiography in the management of MR and MS was 86 % and 57 %, respectively.
  
  
  CONCLUSIONS
  This study showed that physical exercise echo can have an important role in the clinical decision-making of challenging patients with MV disease. Exercise echocardiography had additional value to the treatment strategy in 71 % of these patients.
authors: Department of Cardiology, University Medical Center Utrecht, HP E03.511, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.
authors: R
authors: R
authors: Jansen
authors: P A M
authors: PA
authors: Kracht
authors: M J
authors: MJ
authors: Cramer
authors: W J
authors: WJ
authors: Tietge
authors: L A
authors: LA
authors: van Herwerden
authors: R J M
authors: RJ
authors: Klautz
authors: J
authors: J
authors: Kluin
authors: S A J
authors: SA
authors: Chamuleau
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