Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
CARDIOPULMONARY EXERCISE TESTING IN ASYMPTOMATIC AORTIC STENOSIS
Session:
Posters - J. Preventive Cardiology
Speaker:
Rita Reis Santos
Congress:
CPC 2021
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Rita Reis Santos ; Bruno ml Rocha; Mariana Sousa Paiva; Daniel a. Gomes; Marisa Trabulo; Maria j. Andrade; Luís Raposo; Anaí Durazzo; Luis Moreno; Miguel Mendes
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Background:</span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> Exercise test is recommended for risk stratification of asymptomatic patients with severe aortic stenosis (AS). Cardiopulmonary</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> Exercise Testing (CPET) may improve the accuracy </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">of exercise capacity quantification, yet there is no defined role of CPET to evaluate asymptomatic AS. <span style="color:black">The aim of this study was t</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"><span style="background-color:white">o assess the feasibility, safety and additional information obtained by CPET in patients with asymptomatic severe AS.</span></span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods:</span></span></strong><strong> </strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">This is a single-center retrospective study of patients with </span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">asymptomatic AS who underwent </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">CPET between December 2016 and November 2020 in our center. AS severity was defined as: aortic valve area (AVA) </span></span><span style="font-size:11pt"><span style="font-family:Symbol"><</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">1 cm<sup>2</sup> or mean transvalvular pressure gradient (G</span></span></span></span><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Pm) </span></span><span style="font-size:11pt"><span style="font-family:Symbol">></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 40 mmHg.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">ll patients underwent a treadmill CPET using an exercise protocol with progressive increase in workload, as tolerated.<span style="color:black"> Exercise was maximal when </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">respiratory exchange ratio</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> (RER)</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">≥1.10. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results:</span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> Overall, 18 patients with severe asymptomatic AS were included (mean age 82 </span></span><span style="font-size:11pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 5 years, 56% male). Mean AVA is 0.86 </span></span><span style="font-size:11pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 0.25 cm<sup>2</sup>, median </span></span></span></span></span><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Symbol">G</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Pm is 44 (41-49) mmHg. When evaluating the standard exercise testing parameters, the most used protocol was a ramp slope one, mean duration of exercise was 9 </span></span><span style="font-size:11pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 2 min and mean measured MET<span style="color:black"><span style="background-color:white">s </span></span>were 5 </span></span><span style="font-size:11pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 1. One patient had angina, 7 patients dropped in systolic pressure > 20 mmHg and 6 patients presented with ST segment depression on electrocardiogram. CPET parameters additionally have shown a peak oxygen consumption (pVO<sub>2</sub>) of 16,6 </span></span><span style="font-size:11pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 4,2 mL/min/kg, a minute ventilation/carbon dioxide production ratio (VE/VCO2) of 35 (33 – 41) and 4 patients had exercise oscillatory ventilation (EOV). Exercise testing was maximal in 9 and 3 patients (per predicted maximum heart rate ≥85% and RER≥ 1.10, respectively). 78% (n=14) <span style="color:black">patients had a non-cardiac exercise limitation. </span> The procedure was safe and well-tolerated, without any life-threatening events and no complex arrhythmias reported. Over a <span style="color:black">median follow up of 10 months, 3 patients underwent surgical valve replacement due to symptomatic AS. </span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Conclusions:</span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> CPET is feasible and safe in patients with asymptomatic AS. It provides additional information identifying non-circulatory causes of the exercise limitation. Whether submaximal parameters are useful as prognostic markers to the workflow treatment of AS is worth being prospectively assessed.</span></span></span></span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site