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The value of exercise test in the prognosis of asymptomatic patients with significant aortic valve stenosis

Marisa Campos Moraes Amato et al. Paulo Jorge Moffa

PURPOSE: To evaluate the exercise test as a prognostic factor for asymptomatic patients with aortic valve stenosis. METHODS: During 60 months 70 patients with aortic valve area <1cm² without any other heart lesion were studied. The patients underwent Dopplerechocardiograms exercise tests (considered positive in the presence of electrocardiographic changes or symptoms) and clinical follow-up in order to determine the onset of symptoms or sudden death. RESULTS: The event-free probability was 50% after 16 months of follow-up. There was no relationship between the occurence of events and the sex or to the transvalvar gradient. However, there was a statistically significant association between the incidence of events (p= 0.0124), valvar area (p= 0.0003) and exercise test results (p= 0.0001). CONCLUSION: Patients with significant aortic stenosis even without symptoms, have a low survival rate and the exercise test is a good prognostic factor during follow-up.

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Ambulatory blood pressure monitoring in individuals with exaggerated blood pressure response to exercise, influence of exercise training

Eliudem Galvão Lima et al. Fernando Herkenhoff Elisardo Corral Vasquez

PURPOSE: To evaluate the effects of exercise training on ergometric test and Ambulatory Blood Pressure Monitoring (ABPM) in normotensive individuals with exaggerated blood pressure response to exercise. METHODS: We studied 22 sedentary and normotensive subjects (mean 44±1 years old) showing an exaggerated systolic blood pressure response (SBP>220mmHg) during a cycloergometric test. These individuals were divided in two groups: sedentary hyperreactive group (SHG) and trained hyperreactive group (THG). The THG was submitted to a 4 month aerobic exercise training program. RESULTS: A program of moderate aerobic exercise did not reduce (P>0.05) ABPM blood pressure levels. However, in the submaximal loads of dynamic exercise we observed a significant fall in the SBP and heart rate (P<0.05). CONCLUSION: Normotensive individuals with exaggerated blood pressure response to dynamical exercise submitted to physical training presented a reduction in their systolic blood pressure and heart rate response during the submaximal loads of the cycloergometric test. The ABPM blood pressure values, however, did not change in both groups. These results suggest the involvement of the sympathetic nervous system in the exaggerated blood pressure response observed in these individuals during dynamic exercise and a corresponding reduction of the sympathetic tonus after training. This effect, apparently, did not extend to their daily activities.

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The value of exercise test in the prognosis of asymptomatic patients with significant aortic valve stenosis

Ambulatory blood pressure monitoring in individuals with exaggerated blood pressure response to exercise, influence of exercise training

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)