University of Liège Hospital, Department of Cardiology, Heart Valve Clinic, Liège, Belgium.
National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore.
Prog Cardiovasc Dis. 2017 Nov-Dec;60(3):342-350. doi: 10.1016/j.pcad.2017.10.004. Epub 2017 Nov 8.
Mitral regurgitation (MR) is the second most common valvular heart disease referred for corrective surgery. Diagnostic and management dilemmas are not uncommon when dealing with MR patients. Exercise testing plays an important role in sorting out some of these clinical challenges. In primary asymptomatic MR, exercise testing allows symptom assessment, confident link of symptoms to valve disease severity, safe deferral of surgery for the next 1-year in patients with preserved exercise capacity, insights into the mechanism of exercise-induced dyspnea and helps in individual risk stratification. Moreover, exercise testing in the form of exercise stress echocardiography is also useful in the evaluation of patients with secondary ischemic MR for risk stratification as well as for the detection of patients with moderate ischemic MR in whom mitral valve repair at the time of surgical revascularization may add benefit.
二尖瓣反流（MR）是第二大常见的瓣膜性心脏病，需要进行矫正手术。在处理 MR 患者时，诊断和治疗方面的难题并不少见。运动试验在解决其中一些临床挑战方面发挥着重要作用。在原发性无症状性 MR 中，运动试验可用于评估症状、明确症状与瓣膜疾病严重程度的关联、在有保留运动能力的患者中安全地将手术推迟至下一年、深入了解运动诱发呼吸困难的机制，并有助于进行个体风险分层。此外，运动负荷超声心动图形式的运动试验也可用于评估继发性缺血性 MR 患者的风险分层，以及检测中度缺血性 MR 患者，这些患者在外科血运重建时行二尖瓣修复可能有益。
