Abstract：
OBJECTIVE: A significant number of individuals with mild mitral stenosis (MS) experience exertional symptoms that are disproportionate to the hemodynamic severity of their condition. This study aims to determine whether exercise-induced left atrial (LA) dysfunction occurs in these patients and whether it is related to the development of symptoms.
METHODS: In this observational study, we recruited 46 patients with mild MS. Echocardiographic measurements were initially taken at rest, followed by a maximal exercise stress test. Patients were then returned to the echocardiography laboratory for post-exercise measurements.
RESULTS: Our study cohort exhibited considerably higher left atrial volume index (LAVI) values (mean: 40.52 ± 18.27) compared to those of a healthy population. Furthermore, the LA reservoir strain (mean: 17.1 ± 8.33) was reduced relative to reference values. Following exercise, there was no change in the LA reservoir strain. However, trans-mitral pressure gradients and systolic pulmonary artery pressures increased. The post-exercise mean trans-mitral gradient was identified as the sole predictor of symptom development in patients with mild MS.
CONCLUSIONS: The LA reservoir strain is already reduced in individuals with mild MS, and exercise does not lead to further decline in LA reservoir function in these cases. To our knowledge, this study is the first to explore the effects of exercise on LA mechanics in MS.
METHODS: In this observational study, we recruited 46 patients with mild MS. Echocardiographic measurements were initially taken at rest, followed by a maximal exercise stress test. Patients were then returned to the echocardiography laboratory for post-exercise measurements.
RESULTS: Our study cohort exhibited considerably higher left atrial volume index (LAVI) values (mean: 40.52 ± 18.27) compared to those of a healthy population. Furthermore, the LA reservoir strain (mean: 17.1 ± 8.33) was reduced relative to reference values. Following exercise, there was no change in the LA reservoir strain. However, trans-mitral pressure gradients and systolic pulmonary artery pressures increased. The post-exercise mean trans-mitral gradient was identified as the sole predictor of symptom development in patients with mild MS.
CONCLUSIONS: The LA reservoir strain is already reduced in individuals with mild MS, and exercise does not lead to further decline in LA reservoir function in these cases. To our knowledge, this study is the first to explore the effects of exercise on LA mechanics in MS.
摘要：
目的：大量轻度二尖瓣狭窄（MS）患者的劳累症状与其病情的血流动力学严重程度不成比例。这项研究旨在确定这些患者是否发生运动诱发的左心房（LA）功能障碍，以及是否与症状的发展有关。
方法：在这项观察性研究中，我们招募了46名轻度MS患者。超声心动图测量最初是在休息时进行的，然后进行最大运动压力测试。然后将患者送回超声心动图实验室进行运动后测量。
结果：与健康人群相比，我们的研究队列显示出明显更高的左心房容积指数（LAVI）值（平均值：40.52±18.27）。此外，LA储层应变(平均值:17.1±8.33)相对于参考值降低。练习后，LA储层应变没有变化。然而,经二尖瓣压力梯度和收缩期肺动脉压升高。运动后平均跨二尖瓣梯度被确定为轻度MS患者症状发展的唯一预测因子。
结论：轻度MS患者的LA储层应变已经降低，在这些情况下，运动不会导致LA储层功能进一步下降。据我们所知,这项研究是首次探索运动对MS中LA力学的影响。
方法：在这项观察性研究中，我们招募了46名轻度MS患者。超声心动图测量最初是在休息时进行的，然后进行最大运动压力测试。然后将患者送回超声心动图实验室进行运动后测量。
结果：与健康人群相比，我们的研究队列显示出明显更高的左心房容积指数（LAVI）值（平均值：40.52±18.27）。此外，LA储层应变(平均值:17.1±8.33)相对于参考值降低。练习后，LA储层应变没有变化。然而,经二尖瓣压力梯度和收缩期肺动脉压升高。运动后平均跨二尖瓣梯度被确定为轻度MS患者症状发展的唯一预测因子。
结论：轻度MS患者的LA储层应变已经降低，在这些情况下，运动不会导致LA储层功能进一步下降。据我们所知,这项研究是首次探索运动对MS中LA力学的影响。
