Decreased exercise capacity in ‘asymptomatic’ patients late after relief of severe pulmonary stenosis and moderate restenosis: evidence for diastolic dysfunction
© Romeih et al; licensee BioMed Central Ltd. 2012
Published: 1 February 2012
We concluded that close and regular follow up of asymptomatic patients with a history of previous intervention for PS and residual moderate PS by stress testing is recommended. This might reveal cardiac functional deterioration, which could be an indicator for the earlier intervention in this group of patients to avoid permanent cardiac dysfunction.
Little is known about the management of moderate pulmonary restenosis after relief for severe pulmonary valve stenosis (PS).We evaluated cardiac response to physical and pharmacological stress late after relief of severe PS in these patients.
Twenty asymptomatic patients with moderate PS were divided into 2 groups: Group I (late after relief of severe PS, n = 9), and Group II (no previous intervention, n = 11). All patients underwent an exercise test, dobutamine stress (DS) MRI, and delayed contrast enhanced MRI. The response to physical and pharmacological stress was compared between both groups.
Impaired exercise capacity in patients with moderate pulmonary restenosis after relief of severe PS is caused by inability to increase RV-SV. This is probably caused by disturbed RV filling properties, which worsen in time.
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