Article metrics

  • citations in SCindeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[=>]
  • visits in previous 30 days:16
  • full-text downloads in 30 days:15
article: 6 from 11  
Back back to result list
Srce i krvni sudovi
2013, vol. 32, iss. 2, pp. 121-124
article language: Serbian
document type: Case Report
doi:10.5937/siks1302121B


The value of dobutamine stress echocardiography test in risk evaluation in patient with asymptomatic severe aortic stenosis and preserved resting ejection fraction: Case report
Klinika za kardiologiju, Klinički centar Srbije, Beograd

e-mail: markobanovic71@gmail.com

Abstract

In aortic stenosis (AS) symptoms usually occur during exercise and, furthermore, most Doppler-echocardiographic indices that are used for assessing AS severity are flow dependent. Changes in loading conditions and contractility may lead to alterations in the severity of lesions, good or poor ventricular contractile reserve, altered volume-dependent compliance of heart chambers, and ventricular arterial coupling. Thus, there may be a need for stress testing and imaging in this setting. Herein we represent a case report of asymptomatic patient with moderate/severe AS and with preserved left ventriculae ejection fraction at rest in whom a low-dose dobutamine stress-echocardiography enabled an accurate assessment of AS severity and gave a better understanding of the optimal time for aortic valve replacement.

Keywords

References

Amato, M.C., Maffa, P.J., Werneer, K.E., i dr. (2001) Treatment decision in asymptomatic aortic valve stenosis: Role of exercise testing. Heart, 86(4): 381
Baumgartner, H., Hung, J., Bermejo, J., Chambers, J.B., Evangelista, A., Griffin, B.P., Iung, B., Otto, C.M., Pellikka, P.A., Quiñones, M. (2009) Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Journal of the American Society of Echocardiography, 22(1): 1-23; quiz 101-2
Bermejo, J., García-Fernández, M.A., Torrecilla, E.G., Bueno, H., Moreno, M., San, R.D., Delcán, J.L. (1996) Effects of dobutamine on doppler echocardiographic indexes of aortic stenosis. Journal of the American College of Cardiology, 28(5): 1206-1213
Brown, M.L., Pellikka, P.A., Schaff, H.V., Scott, C.G., Mullany, C.J., Sundt, T.M., Dearani, J.A., Daly, R.C., Orszulak, T.A. (2008) The benefits of early valve replacement in asymptomatic patients with severe aortic stenosis. Journal of Thoracic and Cardiovascular Surgery, 135(2): 308-315
Das, P. (2003) Determinants of symptoms and exercise capacity in aortic stenosis: a comparison of resting haemodynamics and valve compliance during dobutamine stress. European Heart Journal, 24(13): 1254-1263
Das, P., Rimington, H., Chambers, J. (2005) Exercise testing to stratify risk in aortic stenosis. Eur Heart J, 26(13); 1309-1313
Flachskampf, F.A., Kavianipour, M. (2012) Varying Hemodynamics and Differences in Prognosis in Patients With Asymptomatic Severe Aortic Stenosis and Preserved Ejection Fraction. Journal of the American College of Cardiology, 59(3): 244-245
Iung, B., Baron, G., Butchart, E.G., Delahaye, F., Gohlke-Bärwolf, C., Levang, O.W., Tornos, P., Vanoverschelde, J., Vermeer, F., Boersma, E., Ravaud, P., Vahanian, A. (2003) A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. European heart journal, 24(13): 1231-43
Lafitte, S., Perlant, M., Reant, P., Serri, K., Douard, H., DeMaria, A., Roudaut, R. (2009) Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis. European Journal of Echocardiography, 10(3): 414-419
Lancelloti, P., Magne, J., Donal, E., i dr. (2012) Clinical outcome in asymptomatic severe aortic stenosis. J Am Coll Cardiol, 59: 235-243
Lancellotti, P., Lebois, F., Simon, M., i dr. (2005) Prognostic importance of quantitative exercise Doppler echocardiography in asymptomatic valvular aortic stenosis. Circulation, 112, 1377-1382
Leon, M.B., Smith, C.R., Mack, M., i dr. (2010) Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery. N Engl J Med, 363(17); 1597-1607
Lorell, B.H., Carabello, B.A. (2000) Left ventricular hypertrophy: Pathogenesis, detection, and prognosis. Circulation, 102(4): 470-9
Marechaux, S., Hachicha, Z., Bellouin, A., Dumesnil, J.G., Meimoun, P., Pasquet, A., Bergeron, S., Arsenault, M., le Tourneau, T., Ennezat, P.V., Pibarot, P. (2010) Usefulness of exercise-stress echocardiography for risk stratification of true asymptomatic patients with aortic valve stenosis. European Heart Journal, 31(11): 1390-1397
Otto, C.M. (2006) Valvular aortic stenosis: disease severity and timing of intervention. Journal of the American College of Cardiology, 47(11): 2141
Picano, E., Pibarot, P., Lancellotti, P., Monin, J.L., Bonow, R.O. (2009) The Emerging Role of Exercise Testing and Stress Echocardiography in Valvular Heart Disease. in: Picano, Eugenio [ed.] Stress Echocardiography, Berlin, Heidelberg: Springer Nature America, Inc, str. 499-521
Ross, J., Braunwald, E.Jr. (1968) Aortic stenosis. Circulation, 38(Suppl 1): 61-7
Williamson, M.A., Gelfand, E.V. (2012) Care of Patients With Apparently Asymptomatic Severe Aortic Valve Stenosis. Clinical Cardiology, 35(12): E29-E34