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Clinical application of stress echocardiography in valvular heart disease: an expert consensus of the Working Group on Valvular Heart Disease of the Polish Cardiac Society.
Plonska-Gosciniak, Edyta; Kukulski, Tomasz; Hryniewiecki, Tomasz; Kasprzak, Jaroslaw D; Kosmala, Wojciech; Olszowska, Maria; Mizia-Stec, Katarzyna; Pysz, Piotr; Zaborska, Beata; Stoklosa, Patrycjusz; Gasior, Zbigniew.
Afiliação
  • Plonska-Gosciniak E; Department of Cardiology, Pomeranian Medical University, Szczecin, Poland
  • Kukulski T; Department of Cardiology, Congenital Heart Disease and Electrotherapy, School of Health Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
  • Hryniewiecki T; Department of Valvular Heart Disease, National Institute of Cardiology, Warsaw, Poland
  • Kasprzak JD; 1st Chair and Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lódz, Poland
  • Kosmala W; Chair and Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland
  • Olszowska M; Department of Cardiac and Vascular Disease, Jagiellonian University Medical College, Kraków, Poland
  • Mizia-Stec K; 1st Chair and Department of Cardiology, School of Medicine in Katowice, Leszek Giec Upper­­Silesian Medical Centre, Medical University of Silesia, Katowice, Poland
  • Pysz P; Department of Cardiology and Structural Heart Diseases, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland; Cardiac Rehabilitation Department, Treatment and Rehabilitation Center, Long­­Term Care Hospital, Jaworze, Poland
  • Zaborska B; Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
  • Stoklosa P; Department of Valvular Heart Disease, National Institute of Cardiology, Warsaw, Poland. pstoklosa@ikard.pl
  • Gasior Z; Chair and Department of Cardiology, Medical University of Silesia, Katowice, Poland
Kardiol Pol ; 78(6): 632-641, 2020 06 25.
Article em En | MEDLINE | ID: mdl-32419441
Valvular heart diseases (VHDs) constitute an increasing problem both as a consequence of population aging and as the sequelae of other heart diseases. Accurate diagnosis is essential for correct clinical decision­making; however, in many patients, transthoracic and transesophageal echocardiography is insufficient. Stress echocardiography (SE) proved to be a useful tool allowing for simultaneous assessment of left ventricular contractile reserve and HVD hemodynamics under conditions of physiological or pharmacological stress. It is recommended for assessing the severity of VHD, guiding the choice of treatment, as well as for surgical risk stratification. It can be applied both in asymptomatic patients with severe VHD and in symptomatic individuals with moderate disease. In patients with VHD, SE can be performed either as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE). The first modality is recommended to unmask symptoms or abnormal blood pressure response in patients with aortic stenosis (AS) who report to be asymptomatic or in those with mitral stenosis with discordance between clinical symptoms and the severity of valve disease on transthoracic echocardiography. In asymptomatic patients with paradoxical low­flow, low­gradient (LFLG) AS, ESE can be used to assess the severity of stenosis. On the other hand, low­dose DSE can be a useful diagnostic tool in classical LFLG AS, providing information on stenosis severity and contractile reserve. Moreover, SE is indicated in patients with prosthetic valve when there is discordance between symptoms and echocardiographic findings. It is also recommended in high­risk surgical patients with VHD with poor functional capacity and more than 2 clinical risk factors. The present paper discusses in detail the use of SE in VHD.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças das Valvas Cardíacas Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças das Valvas Cardíacas Idioma: En Ano de publicação: 2020 Tipo de documento: Article