open access

Vol 13, No 4 (2018)
Review Papers
Published online: 2018-09-12
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Assessment of valvular heart diseases using exercise electrocardiography and stress echocardiography: still needed approach?

Sigita Glaveckaite, Dovile Petrikonyte, Lidija Latveniene, Pranas Serpytis, Aleksandras Laucevicius
DOI: 10.5603/FC.2018.0070
·
Folia Cardiologica 2018;13(4):318-330.

open access

Vol 13, No 4 (2018)
Review Papers
Published online: 2018-09-12

Abstract

The role of exercise electrocardiography (ECG) and stress echocardiography (SE) in the management of patients with valvular heart diseases (VHD) has been reviewed in this article relying on the recent evidence and the recommendations of the European Society of Cardiology/European Association of Cardio-Thoracic Surgery (ESC/EACTS) and the American College of Cardiology/American Heart Association (ACC/AHA) guidelines on the management of VHD. Both guidelines emphasise the role of exercise ECG to unmask objectively the occurrence of symptoms in patients, who deny symptoms or have doubtful symptoms; however, the role of SE to assess the haemodynamic component of VHD and unmask subclinical myocardial dysfunction is questioned. The above-mentioned guidelines strongly recommend deciding regarding valve surgery according to the presence of symptoms and the left ventricular (LV) morphological and functional parameters assessed at rest. SE can be useful in selected VHD patients for the determination of prognosis, clarification of symptoms and deciding on the timing of surgery. Despite existing evidence, there is still a need for randomised clinical outcome trials evaluating the role of stress imaging in the daily practise decision-making.

Abstract

The role of exercise electrocardiography (ECG) and stress echocardiography (SE) in the management of patients with valvular heart diseases (VHD) has been reviewed in this article relying on the recent evidence and the recommendations of the European Society of Cardiology/European Association of Cardio-Thoracic Surgery (ESC/EACTS) and the American College of Cardiology/American Heart Association (ACC/AHA) guidelines on the management of VHD. Both guidelines emphasise the role of exercise ECG to unmask objectively the occurrence of symptoms in patients, who deny symptoms or have doubtful symptoms; however, the role of SE to assess the haemodynamic component of VHD and unmask subclinical myocardial dysfunction is questioned. The above-mentioned guidelines strongly recommend deciding regarding valve surgery according to the presence of symptoms and the left ventricular (LV) morphological and functional parameters assessed at rest. SE can be useful in selected VHD patients for the determination of prognosis, clarification of symptoms and deciding on the timing of surgery. Despite existing evidence, there is still a need for randomised clinical outcome trials evaluating the role of stress imaging in the daily practise decision-making.

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Keywords

exercise electrocardiography, stress echocardiography, dobutamine echocardiography, exercise echocardiography, stress imaging, valvular heart diseases

About this article
Title

Assessment of valvular heart diseases using exercise electrocardiography and stress echocardiography: still needed approach?

Journal

Folia Cardiologica

Issue

Vol 13, No 4 (2018)

Pages

318-330

Published online

2018-09-12

DOI

10.5603/FC.2018.0070

Bibliographic record

Folia Cardiologica 2018;13(4):318-330.

Keywords

exercise electrocardiography
stress echocardiography
dobutamine echocardiography
exercise echocardiography
stress imaging
valvular heart diseases

Authors

Sigita Glaveckaite
Dovile Petrikonyte
Lidija Latveniene
Pranas Serpytis
Aleksandras Laucevicius

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