Petkow Dimitrow Pawel, Cotrim Carlos, Cheng Tsung O
2nd Department of Cardiology CMUJ, 31-501 Cracow, Poland.
Cardiovasc Ultrasound. 2014 Jul 14;12:26. doi: 10.1186/1476-7120-12-26.
(Semi) supine exercise testing has an established role in the evaluation of patients with valvular heart disease and can help clinical decision making. Stress echocardiography has the advantages of its wide availability, low cost, and versatility for the assessment of disease severity. However, exercise-induced changes in valve hemodynamics, left ventricular outflow obstruction and pulmonary artery pressure depended on load variation. Changing position from supine to upright rapidly decreases load conditions for the ventricles. Therefore several cardiac centers have proposed exercise stress echocardiography in the upright position with gradient monitoring sometimes also in post-exercise recovery. Doppler measurement of subaortic gradient has been a very helpful and informative examination in several heart diseases (especially in hypertrophic cardiomyopathy, valve heart diseases, prosthesis dysfunction).
（半）仰卧位运动试验在评估瓣膜性心脏病患者中具有既定作用，有助于临床决策。负荷超声心动图具有广泛可用、成本低以及在评估疾病严重程度方面具有多功能性的优点。然而，运动引起的瓣膜血流动力学、左心室流出道梗阻和肺动脉压力变化取决于负荷变化。从仰卧位迅速改变为直立位会迅速降低心室的负荷条件。因此，一些心脏中心提出了直立位运动负荷超声心动图检查，有时还会在运动后恢复过程中监测梯度。主动脉瓣下梯度的多普勒测量在几种心脏病（尤其是肥厚型心肌病、瓣膜性心脏病、人工瓣膜功能障碍）中是一项非常有用且信息丰富的检查。
