Acute effect of static exercise in patients with aortic regurgitation assessed by cardiovascular magnetic resonance: role of left ventricular remodelling

Eur Radiol. 2017 Apr;27(4):1424-1430. doi: 10.1007/s00330-016-4520-2. Epub 2016 Aug 23.

Abstract

Objective: In patients with aortic regurgitation (AR), the effect of static exercise (SE) on global ventricular function and AR severity has not been previously studied.

Methods: Resting and SE cardiovascular magnetic resonance (CMR) were prospectively performed in 23 asymptomatic patients with AR.

Results: During SE, we observed a decrease in regurgitant volume in both end-diastolic (EDV) and end-systolic (ESV) volume in both ventricles, as well as a slight decrease in LV ejection fraction (EF). Interestingly, responses varied depending on the degree of LV remodelling. Among patients with a greater degree of LV remodelling, we observed a decrease in LVEF (56 ± 4 % at rest vs 48 ± 7 % during SE, p = 0.001) as a result of a lower decrease in LVESV (with respect to LVEDV. Among patients with a lower degree of LV remodelling, LVEF remained unchanged. RVEF remained unchanged in both groups.

Conclusions: In patients with AR, SE provoked a reduction in preload, LV stroke volume, and regurgitant volume. In those patients with higher LV remodelling, we observed a decrease in LVEF, suggesting a lower LV contractile reserve.

Key points: • In patients with aortic regurgitation, static exercise reduced preload volume. • In patients with aortic regurgitation, static exercise reduced stroke volume. • In patients with aortic regurgitation, static exercise reduced regurgitant volume. • In patients with greater remodelling, static exercise unmasked a lower contractile reserve. • Effect of static exercise on aortic regurgitation was assessed by cardiac MR.

Keywords: Aortic regurgitation; Cardiovascular magnetic resonance; Left ventricular remodelling; Static exercise; Ventricular function.

MeSH terms

  • Adult
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / physiopathology
  • Aortic Valve Insufficiency / diagnostic imaging*
  • Aortic Valve Insufficiency / physiopathology*
  • Exercise / physiology*
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Humans
  • Magnetic Resonance Spectroscopy / methods*
  • Male
  • Prospective Studies
  • Rest
  • Ventricular Remodeling / physiology*