Clinical significance of exercise pulmonary hypertension in secondary mitral regurgitation

The American Journal of Cardiology
Patrizio LancellottiLuc A Piérard

Abstract

In patients with heart failure, exercise echocardiography can help in risk stratification and decision making. The prognostic significance of exercise pulmonary hypertension (PH) in patients with secondary mitral regurgitation (MR) remains unknown. The aim of the present study was to assess the prognostic value of exercise PH in patients with secondary MR and narrow QRS intervals. From 2005 to 2012, 159 consecutive patients with secondary MR, narrow QRS intervals, left ventricular dysfunction (mean ejection fraction 36 ± 7%), and measurable systolic pulmonary arterial pressure (SPAP) during exercise echocardiography were included. Resting and exercise PH were defined as SPAP >50 and >60 mm Hg, respectively. Exercise PH was more frequent than resting PH (40% vs 13%, p <0.0001). On multivariate logistic regression, the independent determinants of exercise PH were resting SPAP (p <0.0001), exercise MR severity (p <0.0001), and e'-wave velocity (p = 0.004). The incidence of cardiac events during follow-up was significantly higher in patients with exercise PH compared with those without exercise PH (4 years: 40 ± 7% vs 20 ± 5%, p <0.0001). Patients with exercise PH exhibited higher rates of cardiac events and death than those with r...Continue Reading

References

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Oct 16, 2004·The New England Journal of Medicine·Luc A Piérard, Patrizio Lancellotti
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Feb 15, 2014·JACC. Cardiovascular Imaging·Julien MagneLuc A Piérard

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Citations

Jan 14, 2016·Journal of Echocardiography·Masaki Izumo, Yoshihiro J Akashi
Oct 29, 2015·European Heart Journal·Stephan RosenkranzJean-Luc Vachiéry
May 20, 2015·Current Treatment Options in Cardiovascular Medicine·Shweta R Motiwala, Francesca N Delling
Jun 7, 2016·The American Journal of Cardiology·Marlieke L A HaeckVictoria Delgado
Jul 9, 2016·Progress in Cardiovascular Diseases·Christophe MartinezPatrizio Lancellotti
Jan 18, 2017·Circulation·Philippe B BertrandPieter M Vandervoort
Feb 2, 2019·Heart·Rajdeep S Khattar, Roxy Senior
Aug 5, 2020·Expert Review of Cardiovascular Therapy·Ross ArenaAntonio Abbate
Aug 29, 2020·European Heart Journal Cardiovascular Imaging·Masaki IzumoYoshihiro J Akashi
Jan 10, 2019·The International Journal of Cardiovascular Imaging·Yasuhiro HamataniChisato Izumi
Jul 18, 2019·Herz·T TichelbäckerS Rosenkranz
Jun 8, 2018·Journal of Echocardiography·Kengo SuzukiMakoto Akaishi
Jun 8, 2018·Frontiers in Cardiovascular Medicine·Micha T MaederHans Rickli

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