Value of Echo-Doppler Derived Pulmonary Vascular Resistance, Net-Atrioventricular Compliance and Tricuspid Annular Velocity in Determining Exercise Capacity in Patients With Mitral Stenosis

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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). Methods and 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 %VO_2 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. (Circ J 2007; 71 : 1721-1727)
社団法人日本循環器学会の論文
2007-10-20