Moderate Exercise Does Not Increase the Severity of Mitral Regurgitation Due to Mitral Valve Prolapse

Background: Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP). Methods: Consecutive patients with asymptomatic MR of varying severity underwent exercise test on...

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Published in:	Echocardiography (Mount Kisco, N.Y.) Vol. 27; no. 9; pp. 1031 - 1037
Main Authors:	Pecini, Redi, Dalsgaard, Morten, Møller, Daniel V., Jensen, Morten S., Kofoed, Klaus F., Nielsen, Walter, Nielsen, Olav W., Høst, Nis, Elming, Hanne, Goetze, Jens Peter, Hassager, Christian, Køber, Lars
Format:	Journal Article
Language:	English
Published:	Malden, USA Blackwell Publishing Inc 01-10-2010
Subjects:	Cardiac output Echocardiography Exercise Exercise (programs) exercise echocardiography Exercise Test Female Heart diseases Humans Male Measurement Middle Aged Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - etiology Mitral Valve Insufficiency - physiopathology mitral valve prolapse Mitral Valve Prolapse - complications Mitral Valve Prolapse - diagnostic imaging Mitral Valve Prolapse - physiopathology Patients Physical Exertion Rest Work load
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Abstract	Background: Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP). Methods: Consecutive patients with asymptomatic MR of varying severity underwent exercise test on a supine bicycle with workload up to a maximum of 100 W. Echocardiographic measurements were performed at rest and at peak exercise. The study was designed to detect an effective regurgitant orifice (ERO) change of at least 10 mm2 during exercise. Results: Twenty‐six patients (21 male, age 56 ± 12 years (mean ± SD)) were included. Patients had an ERO of 35 ± 23 mm2 (mean ± SD) and regurgitation volume of 48 ± 38 mL (mean ± SD). In these patients, ERO remained unchanged (an increase of 2 ± 15 mm2 during exercise, P = 0.6). The regurgitation volume (RVol) decreased with 11 ± 16 mL (mean ± SD), P = 0.003. When calculated for 1 minute, RVol increased during exercise (P = 0.01), but in relation to the total cardiac output it decreased significantly (P = 0.02). Conclusion: Exercise does not increase the severity of MR due to MVP, in contrast to MR secondary to IHD. Different disease mechanisms behind these two types of MR could explain this difference. (Echocardiography 2010;27:1031‐1037)
AbstractList	Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP). Consecutive patients with asymptomatic MR of varying severity underwent exercise test on a supine bicycle with workload up to a maximum of 100 W. Echocardiographic measurements were performed at rest and at peak exercise. The study was designed to detect an effective regurgitant orifice (ERO) change of at least 10 mm² during exercise. Twenty-six patients (21 male, age 56 ± 12 years (mean ± SD)) were included. Patients had an ERO of 35 ± 23 mm² (mean ± SD) and regurgitation volume of 48 ± 38 mL (mean ± SD). In these patients, ERO remained unchanged (an increase of 2 ± 15 mm² during exercise, P = 0.6). The regurgitation volume (RVol) decreased with 11 ± 16 mL (mean ± SD), P = 0.003. When calculated for 1 minute, RVol increased during exercise (P = 0.01), but in relation to the total cardiac output it decreased significantly (P = 0.02). Exercise does not increase the severity of MR due to MVP, in contrast to MR secondary to IHD. Different disease mechanisms behind these two types of MR could explain this difference. Background: Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP). Methods: Consecutive patients with asymptomatic MR of varying severity underwent exercise test on a supine bicycle with workload up to a maximum of 100 W. Echocardiographic measurements were performed at rest and at peak exercise. The study was designed to detect an effective regurgitant orifice (ERO) change of at least 10 mm 2 during exercise. Results: Twenty‐six patients (21 male, age 56 ± 12 years (mean ± SD)) were included. Patients had an ERO of 35 ± 23 mm 2 (mean ± SD) and regurgitation volume of 48 ± 38 mL (mean ± SD). In these patients, ERO remained unchanged (an increase of 2 ± 15 mm 2 during exercise, P = 0.6). The regurgitation volume (RVol) decreased with 11 ± 16 mL (mean ± SD), P = 0.003. When calculated for 1 minute, RVol increased during exercise (P = 0.01), but in relation to the total cardiac output it decreased significantly (P = 0.02). Conclusion: Exercise does not increase the severity of MR due to MVP, in contrast to MR secondary to IHD. Different disease mechanisms behind these two types of MR could explain this difference. (Echocardiography 2010;27:1031‐1037) BACKGROUNDMitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP).METHODSConsecutive patients with asymptomatic MR of varying severity underwent exercise test on a supine bicycle with workload up to a maximum of 100 W. Echocardiographic measurements were performed at rest and at peak exercise. The study was designed to detect an effective regurgitant orifice (ERO) change of at least 10 mm² during exercise.RESULTSTwenty-six patients (21 male, age 56 ± 12 years (mean ± SD)) were included. Patients had an ERO of 35 ± 23 mm² (mean ± SD) and regurgitation volume of 48 ± 38 mL (mean ± SD). In these patients, ERO remained unchanged (an increase of 2 ± 15 mm² during exercise, P = 0.6). The regurgitation volume (RVol) decreased with 11 ± 16 mL (mean ± SD), P = 0.003. When calculated for 1 minute, RVol increased during exercise (P = 0.01), but in relation to the total cardiac output it decreased significantly (P = 0.02).CONCLUSIONExercise does not increase the severity of MR due to MVP, in contrast to MR secondary to IHD. Different disease mechanisms behind these two types of MR could explain this difference. Background: Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP). Methods: Consecutive patients with asymptomatic MR of varying severity underwent exercise test on a supine bicycle with workload up to a maximum of 100 W. Echocardiographic measurements were performed at rest and at peak exercise. The study was designed to detect an effective regurgitant orifice (ERO) change of at least 10 mm2 during exercise. Results: Twenty-six patients (21 male, age 56 plus or minus 12 years (mean plus or minus SD)) were included. Patients had an ERO of 35 plus or minus 23 mm2 (mean plus or minus SD) and regurgitation volume of 48 plus or minus 38 mL (mean plus or minus SD). In these patients, ERO remained unchanged (an increase of 2 plus or minus 15 mm2 during exercise, P = 0.6). The regurgitation volume (RVol) decreased with 11 plus or minus 16 mL (mean plus or minus SD), P = 0.003. When calculated for 1 minute, RVol increased during exercise (P = 0.01), but in relation to the total cardiac output it decreased significantly (P = 0.02). Conclusion: Exercise does not increase the severity of MR due to MVP, in contrast to MR secondary to IHD. Different disease mechanisms behind these two types of MR could explain this difference. (Echocardiography 2010; 27:1031-1037) Background: Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP). Methods: Consecutive patients with asymptomatic MR of varying severity underwent exercise test on a supine bicycle with workload up to a maximum of 100 W. Echocardiographic measurements were performed at rest and at peak exercise. The study was designed to detect an effective regurgitant orifice (ERO) change of at least 10 mm2 during exercise. Results: Twenty‐six patients (21 male, age 56 ± 12 years (mean ± SD)) were included. Patients had an ERO of 35 ± 23 mm2 (mean ± SD) and regurgitation volume of 48 ± 38 mL (mean ± SD). In these patients, ERO remained unchanged (an increase of 2 ± 15 mm2 during exercise, P = 0.6). The regurgitation volume (RVol) decreased with 11 ± 16 mL (mean ± SD), P = 0.003. When calculated for 1 minute, RVol increased during exercise (P = 0.01), but in relation to the total cardiac output it decreased significantly (P = 0.02). Conclusion: Exercise does not increase the severity of MR due to MVP, in contrast to MR secondary to IHD. Different disease mechanisms behind these two types of MR could explain this difference. (Echocardiography 2010;27:1031‐1037)
Author	Møller, Daniel V. Nielsen, Walter Goetze, Jens Peter Dalsgaard, Morten Kofoed, Klaus F. Jensen, Morten S. Pecini, Redi Elming, Hanne Hassager, Christian Nielsen, Olav W. Køber, Lars Høst, Nis
Author_xml	– sequence: 1 givenname: Redi surname: Pecini fullname: Pecini, Redi organization: Cardiology Department, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark – sequence: 2 givenname: Morten surname: Dalsgaard fullname: Dalsgaard, Morten organization: Cardiology Department, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark – sequence: 3 givenname: Daniel V. surname: Møller fullname: Møller, Daniel V. organization: Cardiology Department, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark – sequence: 4 givenname: Morten S. surname: Jensen fullname: Jensen, Morten S. organization: Cardiology Department, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark – sequence: 5 givenname: Klaus F. surname: Kofoed fullname: Kofoed, Klaus F. organization: Cardiology Department, University of Copenhagen, Hvidovre Hospital, Copenhagen, Denmark – sequence: 6 givenname: Walter surname: Nielsen fullname: Nielsen, Walter organization: Cardiology Department, University of Copenhagen, Hvidovre Hospital, Copenhagen, Denmark – sequence: 7 givenname: Olav W. surname: Nielsen fullname: Nielsen, Olav W. organization: Cardiology Department, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmak – sequence: 8 givenname: Nis surname: Høst fullname: Høst, Nis organization: Cardiology Department, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmak – sequence: 9 givenname: Hanne surname: Elming fullname: Elming, Hanne organization: Cardiology Department, University of Copenhagen, Roskilde Hospital, Roskilde, Denmark – sequence: 10 givenname: Jens Peter surname: Goetze fullname: Goetze, Jens Peter organization: Department of Clinical Biochemistry, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark – sequence: 11 givenname: Christian surname: Hassager fullname: Hassager, Christian organization: Cardiology Department, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark – sequence: 12 givenname: Lars surname: Køber fullname: Køber, Lars organization: Cardiology Department, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Snippet	Background: Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true... Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due... BACKGROUNDMitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true...
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SubjectTerms	Cardiac output Echocardiography Exercise Exercise (programs) exercise echocardiography Exercise Test Female Heart diseases Humans Male Measurement Middle Aged Mitral Valve Insufficiency - diagnostic imaging Mitral Valve Insufficiency - etiology Mitral Valve Insufficiency - physiopathology mitral valve prolapse Mitral Valve Prolapse - complications Mitral Valve Prolapse - diagnostic imaging Mitral Valve Prolapse - physiopathology Patients Physical Exertion Rest Work load
Title	Moderate Exercise Does Not Increase the Severity of Mitral Regurgitation Due to Mitral Valve Prolapse
URI	https://api.istex.fr/ark:/67375/WNG-Q6R78632-6/fulltext.pdf https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1540-8175.2010.01200.x https://www.ncbi.nlm.nih.gov/pubmed/21039809 https://search.proquest.com/docview/762274386 https://search.proquest.com/docview/954613619
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