The importance of exercise echocardiography for clinical decision making in primary mitral regurgitation

J Cardiovasc Med (Hagerstown). 2012 Apr;13(4):260-5. doi: 10.2459/JCM.0b013e3283515c70.

Abstract

Primary mitral regurgitation is generally an insidious disease with late onset of symptoms. Current European and American guidelines recommend surgery in severe primary mitral regurgitation when symptoms, overt left ventricular dysfunction, pulmonary hypertension or atrial fibrillation, occur. However, recent large studies reported an improved outcome in asymptomatic patients with severe mitral regurgitation referred for early mitral valve repair despite the risk of operative mortality or mitral valve replacement. Moreover, primary mitral regurgitation appears to have an important dynamic character in up to one-third of patients. This article provides an overview of the incremental evidence of the ability of exercise echocardiography to assess the functional repercussions of mitral regurgitation and the identification of high-risk patients who might benefit from early referral for surgery.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures / adverse effects
  • Echocardiography, Stress*
  • Exercise Test*
  • Hemodynamics
  • Humans
  • Mitral Valve / diagnostic imaging*
  • Mitral Valve / physiopathology
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency / diagnostic imaging*
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery
  • Patient Selection
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index