Roşca Monica, Lancellotti Patrizio, Magne Julien, Piérard Luc A
Department of Cardiology, University Hospital, CHU Sart Tilman, University of Liège, Liège, Belgium.
Expert Rev Cardiovasc Ther. 2011 Jan;9(1):81-92. doi: 10.1586/erc.10.173.
Symptom development represents one of the most important indications for surgical intervention in patients with significant valvular heart disease. Exercise testing has an established role in the assessment of exercise capacity and symptomatic status in patients with severe valvular heart disease who claim to be asymptomatic. In these patients, clinical decision can be influenced by the results of exercise testing. In addition to the assessment of symptomatic response to exercise, stress echocardiography can provide valuable information on exercise-induced changes in valve hemodynamics, ventricular function and pulmonary artery pressure. Abnormal left ventricular response to exercise, increase in pulmonary pressure or change in the hemodynamic severity of the valvular disease adds to the prognostic value of elicited symptoms. In this article we discuss the validated indications, proven prognostic values and potential influence on clinical decisions of stress echocardiography in left valvular heart diseases.
症状发展是重度瓣膜性心脏病患者手术干预的最重要指征之一。运动试验在评估自称无症状的重度瓣膜性心脏病患者的运动能力和症状状态方面具有既定作用。在这些患者中，临床决策可能会受到运动试验结果的影响。除了评估运动的症状反应外，负荷超声心动图还可以提供有关运动引起的瓣膜血流动力学、心室功能和肺动脉压力变化的有价值信息。左心室对运动的异常反应、肺压力升高或瓣膜疾病血流动力学严重程度的变化增加了诱发症状的预后价值。在本文中，我们讨论了负荷超声心动图在左瓣膜性心脏病中的有效指征、已证实的预后价值以及对临床决策的潜在影响。
