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Determinants and Prognostic Significance of Exercise Pulmonary Hypertension in Asymptomatic Severe Aortic Stenosis
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Background—: Recent studies emphasized the usefulness of exercise stress echocardiography in asymptomatic patients with aortic stenosis. Nevertheless, the additive value of exercise pulmonary hypertension (Ex-PHT) in such patients remains unexplored. We therefore aimed to identify the determinants and to test the impact on outcome of Ex-PHT in asymptomatic patients with severe aortic stenosis. Method and Results—: Asymptomatic patients with severe aortic stenosis (n=105; aortic valve area <0.6 cm 2 /m 2 ; age, 71±9 years; male, 59%) and preserved left ventricular systolic function (ejection fraction ≥55%) were prospectively submitted to exercise stress echocardiography. Resting PHT and Ex-PHT were defined as a systolic pulmonary arterial pressure >50 and >60 mm Hg, respectively. Ex-PHT was more frequent than resting PHT (55% versus 6%; P <0.0001). On multivariable logistic regression, the independent predictors of Ex-PHT were male sex (odds ratio, 4.3; P =0.002), resting systolic pulmonary arterial pressure (odds ratio, 1.16; P =0.002), exercise indexed left ventricular end-diastolic volume (odds ratio, 1.04; P =0.026), exercise e′-wave velocity (odds ratio, 1.35; P =0.047), and exercise-induced changes in indexed left atrial area (odds ratio, 1.36; P =0.006). Ex-PHT was associated with reduced cardiac event-free survival (at 3 years, 22±7% versus 55±9%; P =0.014). In a multivariable Cox proportional hazards model, Ex-PHT was identified as an independent predictor of cardiac events (hazard ratio, 1.8; 95% confidence interval, 1.0–3.3; P =0.047). When exercise-induced changes in mean aortic pressure gradient were added to the multivariable model, Ex-PHT remained independently associated with reduced cardiac event-free survival (hazard ratio, 2.0; 95% confidence interval, 1.1–3.6; P =0.025). Conclusions—: In asymptomatic patients with severe aortic stenosis, the main determinants of Ex-PHT are male sex, resting systolic pulmonary arterial pressure, and exercise parameters of diastolic burden. Moreover, Ex-PHT is associated with a 2-fold increased risk of cardiac events. These results strongly support the use of exercise stress echocardiography in asymptomatic aortic stenosis.
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“In the more advanced stages of the disease, the increased LV filling pressures lead to secondary pulmonary hypertension and dyspnoea symptoms126;127.”
From Calcific aortic stenosis (2016) · cites this paper as [127]
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Cites
ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease
Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C., Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O’Gara, P. T., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.176857 · Cited by 8,487
Guidelines on the management of valvular heart disease
Vahanian, A. S., Baumgartner, H., Bax, J. J., Butchart, E., Dion, R., Filippatos, G. S., Flachskampf, F., Hall, R., Iung, B., Kasprzak, J. D., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehl428 · Cited by 3,579
Self-citationACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease
Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C., Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O’Gara, P. T., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.05.021 · Cited by 1,702
Rodés‐Cabau, J., Webb, J. G., Cheung, A. W., Ye, J., Dumont, É., Feindel, C. M., Osten, M., Natarajan, M. K., Velianou, J. L., Martucci, G. J., et al. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.12.014 · Cited by 970
Impact of Myocardial Fibrosis in Patients With Symptomatic Severe Aortic Stenosis
Weidemann, F., Herrmann, S., Störk, S., Niemann, M., Frantz, S., Lange, V., Beer, M., Gattenlöhner, S., Voelker, W., Ertl, G., et al. (2009) · Circulation · doi:10.1161/circulationaha.108.847772 · Cited by 706
Lancellotti, P., Lebois, F., Simon, M. A. M., Tombeux, C., Chauvel, C., & Piérard, L. (2005) · Circulation · doi:10.1161/circulationaha.104.523274 · Cited by 341
Self-citationLancellotti, P., Donal, E., Magne, J., Moonen, M., O'Connor, K., Daubert, J.-C., & Pierard, L. A. (2010) · Heart · doi:10.1136/hrt.2009.190942 · Cited by 321
Self-citationGuidelines on the management of valvular heart disease: reply
Vahanian, P. A. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm095 · Cited by 308
Early Surgery Versus Conventional Treatment in Asymptomatic Very Severe Aortic Stenosis
Kang, D., Park, S., Rim, J. H., Yun, S., Kim, D., Song, J., Choo, S. J., Park, S. W., Song, J., Lee, J., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.909903 · Cited by 298
Low-Gradient Aortic Valve Stenosis
Herrmann, S., Störk, S., Niemann, M., Lange, V., Strotmann, J. M., Frantz, S., Beer, M., Gattenlöhner, S., Voelker, W., Ertl, G., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.02.059 · Cited by 292
Maréchaux, S., Hachicha, Z., Bellouin, A., Dumesnil, J. G., Meimoun, P., Pasquet, A., Bergeron, S., Arsenault, M., Tourneau, T. L., Ennezat, P. V., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq076 · Cited by 279
Exercise Pulmonary Hypertension in Asymptomatic Degenerative Mitral Regurgitation
Magné, J., Lancellotti, P., & Piérard, L. (2010) · Circulation · doi:10.1161/circulationaha.110.938241 · Cited by 267
Self-citationRisk Score for Predicting Outcome in Patients With Asymptomatic Aortic Stenosis
Monin, J., Lancellotti, P., Monchi, M., Lim, P., Weiss, E., Piérard, L., & Guéret, P. (2009) · Circulation · doi:10.1161/circulationaha.108.808857 · Cited by 204
Self-citationLong-term follow-up after isolated aortic valve replacement
Copeland, J. G., Griepp, R. B., Stinson, E. B., & Shumway, N. E. (1977) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)41186-0 · Cited by 203
Malouf, J. F., Enriquez-Sarano, M. L., Pellikka, P. A., Oh, J. K., Bailey, K. R., Chandrasekaran, K., Mullany, C. J., & Tajik, A. J. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02002-8 · Cited by 202
Exercise-Induced Changes in Degenerative Mitral Regurgitation
Magné, J., Lancellotti, P., & Piérard, L. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.12.073 · Cited by 193
Self-citationImpact of Atrioventricular Compliance on Pulmonary Artery Pressure in Mitral Stenosis
Schwammenthal, E., Vered, Z., Agranat, O., Kaplinsky, E., Rabinowitz, B., & Feinberg, M. S. (2000) · Circulation · doi:10.1161/01.cir.102.19.2378 · Cited by 166
Lancellotti, P., Moonen, M., Magne, J., O'Connor, K., Cosyns, B., Attena, E., Donal, E., & Pierard, L. (2010) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2009.09.043 · Cited by 137
Self-citationTumminello, G., Lancellotti, P., Lempereur, M., D’Orio, V., & Piérard, L. (2006) · European Heart Journal · doi:10.1093/eurheartj/ehl561 · Cited by 108
Self-citationPulmonary artery hypertension in severe aortic stenosis: Incidence and mechanism
Silver, K. H., Aurigemma, G. P., Krendel, S., Barry, N., Ockene, I. S., & Alpert, J. S. (1993) · American Heart Journal · doi:10.1016/0002-8703(93)90067-j · Cited by 97
Assessment of Pulmonary Arterial Pressure During Exercise in Collagen Vascular Disease
Kovács, G., Maier, R., Aberer, E., Brodmann, M., Scheidl, S. J., Hesse, C., Troester, N., Salmhofer, W., Stauber, R. E., Fuerst, F. C., et al. (2010) · CHEST Journal · doi:10.1378/chest.09-2099 · Cited by 92
Left atrial function and remodelling in aortic stenosis
O’Connor, K. P., Magné, J., Roşca, M., Piérard, L., & Lancellotti, P. (2011) · European Journal of Echocardiography · doi:10.1093/ejechocard/jer006 · Cited by 88
Self-citationImpact of Aortic Valve Stenosis on Left Atrial Phasic Function
O’Connor, K., Magné, J., Roşca, M., Piérard, L., & Lancellotti, P. (2010) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2010.06.029 · Cited by 76
Self-citationElevated Pulmonary Artery Pressure
Cooper, R., Ghali, J. K., Simmons, B. E., & Castañer, A. (1991) · CHEST Journal · doi:10.1378/chest.99.1.112 · Cited by 65
Pulmonary hypertension in isolated aortic stenosis
Johnson, L. W., Hapanowicz, M. B., Buonanno, C., Bowser, M. A., Marvasti, M. A., & Parker, F. B. (1988) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)35725-3 · Cited by 65
Effects of age on pulmonary artery systolic pressure at rest and during exercise in normal adults
Mahjoub, H., Lévy, F., Cassol, M., Meimoun, P., Peltier, M., Ruşinaru, D., & Tribouilloy, C. (2009) · European Journal of Echocardiography · doi:10.1093/ejechocard/jep024 · Cited by 64
Pai, R. G., Varadarajan, P., Kapoor, N., & Bansal, R. C. (2007) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2007.02.094 · Cited by 61
Echocardiographic predictors of pulmonary hypertension in patients with severe aortic stenosis
Kapoor, N., Varadarajan, P., & PAI, R. (2007) · European Journal of Echocardiography · doi:10.1016/j.euje.2007.01.005 · Cited by 58
Prognostic implications of pulmonary hypertension in patients with severe aortic stenosis
Çam, A., Goel, S. S., Agarwal, S., Menon, V., Svensson, L. G., Tuzcu, E. M., & Kapadia, S. R. (2011) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2010.12.024 · Cited by 56
Reversibility of pulmonary artery hypertension in aortic stenosis after aortic valve replacement
Tracy, G. P., Proctor, M. S., & Hizny, C. S. (1990) · The Annals of Thoracic Surgery · doi:10.1016/0003-4975(90)90095-n · Cited by 50
Pulmonary hypertension and sudden death in aortic stenosis.
McHenry, M. M., Rice, J., Matlof, H. J., & Flamm, M. D. (1979) · Heart · doi:10.1136/hrt.41.4.463 · Cited by 46
Short- and mid-term results for aortic valve replacement in octogenarians
Carnero, M., Reguillo, F., Alswies, A., Villagrán-Medinilla, E., Maroto-Castellanos, L. C., & Rodríguez-Hernández, J. E. (2010) · Interactive Cardiovascular and Thoracic Surgery · doi:10.1510/icvts.2009.218040 · Cited by 40
E/Ea is the Major Determinant of Pulmonary Artery Pressure in Moderate to Severe Aortic Stenosis
Casaclang‐Verzosa, G., Nkomo, V. T., Enriquez-Sarano, M. L., Malouf, J. F., Miller, F. A., & Oh, J. K. (2008) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2007.12.002 · Cited by 36
Saraiva, R. M., Yamano, T., Matsumura, Y., Takasaki, K., Toyono, M., Agler, D. A., Greenberg, N. L., Thomas, J. D., & Shiota, T. (2009) · American Heart Journal · doi:10.1016/j.ahj.2009.05.030 · Cited by 31
Buonanno, C., Johnson, L. W., Bowser, M. A., Hapanowicz, M. B., Marvasti, M. A., & Parker, F. B. (1987) · PubMed · Cited by 8
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Baumgartner, H., Hung, J., Bermejo, J., Chambers, J. B., Edvardsen, T., Goldstein, S., Lancellotti, P., LeFevre, M., Miller, F. A., & Otto, C. M. (2017) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2017.02.009 · Cited by 1,357
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Praz, F., Borger, M. A., Lanz, J., Cuartas, M. M., Abreu, A., Adamo, M., Marsan, N. A., Barili, F., Bonaros, N. E., Cosyns, B., et al. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf194 · Cited by 1,364
Self-citationLindman, B. R., Clavel, M.-A., Mathieu, P., Iung, B., Lancellotti, P., Otto, C. M., & Pibarot, P. (2016) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2016.6 · Cited by 982
Self-citationBaumgartner, H., Hung, J., Bermejo, J., Chambers, J. B., Edvardsen, T., Goldstein, S., Lancellotti, P., LeFevre, M., Miller, F. A., & Otto, C. M. (2016) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jew335 · Cited by 764
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Metadata
- Authors
- Lancellotti, P., Magne, J., Donal, E., O'Connor, K., Dulgheru, R., Rosca, M., & Pierard, L. A.
- Affiliations
- Inserm (FR)
- From the University of Liège, Department of Cardiology and GIGA Cardiovascular Sciences, University Hospital, Sart Tilman, Liège, Belgium (P.L., J.M., K.O., R.D., M.R., L.A.P.), and Cardiology Department, CIC-IT 804, LTSI INSERM U 642, Pontchaillou University Medical Center, Rennes, France (E.D.).
- Venue
- Circulation
- Published
- 2012-08-14
- Volume
- 126
- Issue
- 7
- Pages
- 851-859
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2008576197
- Cited by
- 216
- References
- 35
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 8 · 2023: 12 · 2022: 14 · 2021: 17 · 2020: 10 · 2019: 20 · 2018: 17 · 2017: 26 · 2016: 20 · 2015: 19 · 2014: 14 · 2013: 17 · 2012: 1
- FWCI
- 10.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- ORBi (University of Liège) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Keywords
- exercise pulmonary hypertension, severe aortic stenosis, asymptomatic aortic stenosis, exercise echocardiography, prognostic factors, cardiac event-free survival, left ventricular end-diastolic volume, E-wave velocity, left atrial area, aortic pressure gradient, male sex, preserved left ventricular systolic function, left ventricular outflow tract obstruction
- MeSH terms
- Aged, Aged, 80 and over, Aortic Valve Stenosis, Exercise Test, Female, Heart Ventricles, Humans, Hypertension, Pulmonary, Male, Middle Aged, Prognosis, Pulmonary Wedge Pressure, Severity of Illness Index, Sex Factors, Stroke Volume, Echocardiography, Stress, Arterial Pressure
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