Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation

Chronic aortic regurgitation (AR) is a valvulopathy of slow and insidious evolution, and patients may remain asymptomatic for a long period of time. Exercise-induced systolic dysfunction occurs during the natural history of chronic AR and is related to changes in both preload and afterload. We descr...

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Main Authors:	Giovani Luiz De Santi, Eduardo Elias Vieira de Carvalho, Daniela Caetano Costa, Júlio César Crescencio, Minna Moreira Dias Romano, André Schmidt, Marcus Vinícius Simões, Lourenço Gallo, Junior
Format:	Article
Language:	English
Published:	Elsevier 2013-05-01
Series:	Revista Portuguesa de Cardiologia
Online Access:	http://www.sciencedirect.com/science/article/pii/S0870255113000747

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spelling	doaj-c78d68c905bd4716ad1fb43c7438fb842020-11-25T02:26:55ZengElsevierRevista Portuguesa de Cardiologia0870-25512013-05-01325419423Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitationGiovani Luiz De Santi0Eduardo Elias Vieira de Carvalho1Daniela Caetano Costa2Júlio César Crescencio3Minna Moreira Dias Romano4André Schmidt5Marcus Vinícius Simões6Lourenço Gallo, Junior7Corresponding author.; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilDivision of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilDivision of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilDivision of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilDivision of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilDivision of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilDivision of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilDivision of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, BrazilChronic aortic regurgitation (AR) is a valvulopathy of slow and insidious evolution, and patients may remain asymptomatic for a long period of time. Exercise-induced systolic dysfunction occurs during the natural history of chronic AR and is related to changes in both preload and afterload. We describe the case of a 58-year-old woman with a diagnosis of chronic AR who reported progressive dyspnea of six years’ duration. A cardiopulmonary exercise test to assess functional capacity showed flattening of both oxygen uptake and oxygen pulse curves, suggesting latent systolic dysfunction related to chronic AR, which was later confirmed by stress Doppler echocardiogram with dynamic physical exercise. Resumo: A Insuficiência Aórtica Crônica (IAC) é uma valvulopatia de evolução lenta e insidiosa podendo o paciente manter-se assintomático por longo período de tempo. A disfunção sistólica induzida pelo esforço ocorre durante a história natural da IAC estando relacionada com alterações nos componentes tanto da pré-carga quanto da pós-carga. Apresentamos o caso de uma paciente do género feminino, de 58 anos, com diagnóstico de IAC que referia queixa de dispneia progressiva com evolução de seis anos. O teste cardiopulmonar foi indicado com intuito de avaliar a capacidade funcional e mostrou platô das curvas de consumo de oxigénio e de pulso de oxigénio, sugerindo disfunção sistólica latente relacionada à insuficiência aórtica crônica; condição posteriormente confirmada pelo Doppler-ecocardiograma de estresse com esforço físico dinâmico. Keywords: Chronic aortic regurgitation, Cardiopulmonary exercise test, Left ventricular dysfunction, Palavras-chave: Insuficiência aórtica crônica, Teste cardiopulmonar, Disfunção ventricular esquerdahttp://www.sciencedirect.com/science/article/pii/S0870255113000747
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Giovani Luiz De Santi Eduardo Elias Vieira de Carvalho Daniela Caetano Costa Júlio César Crescencio Minna Moreira Dias Romano André Schmidt Marcus Vinícius Simões Lourenço Gallo, Junior
spellingShingle	Giovani Luiz De Santi Eduardo Elias Vieira de Carvalho Daniela Caetano Costa Júlio César Crescencio Minna Moreira Dias Romano André Schmidt Marcus Vinícius Simões Lourenço Gallo, Junior Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation Revista Portuguesa de Cardiologia
author_facet	Giovani Luiz De Santi Eduardo Elias Vieira de Carvalho Daniela Caetano Costa Júlio César Crescencio Minna Moreira Dias Romano André Schmidt Marcus Vinícius Simões Lourenço Gallo, Junior
author_sort	Giovani Luiz De Santi
title	Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation
title_short	Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation
title_full	Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation
title_fullStr	Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation
title_full_unstemmed	Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation
title_sort	contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation
publisher	Elsevier
series	Revista Portuguesa de Cardiologia
issn	0870-2551
publishDate	2013-05-01
description	Chronic aortic regurgitation (AR) is a valvulopathy of slow and insidious evolution, and patients may remain asymptomatic for a long period of time. Exercise-induced systolic dysfunction occurs during the natural history of chronic AR and is related to changes in both preload and afterload. We describe the case of a 58-year-old woman with a diagnosis of chronic AR who reported progressive dyspnea of six years’ duration. A cardiopulmonary exercise test to assess functional capacity showed flattening of both oxygen uptake and oxygen pulse curves, suggesting latent systolic dysfunction related to chronic AR, which was later confirmed by stress Doppler echocardiogram with dynamic physical exercise. Resumo: A Insuficiência Aórtica Crônica (IAC) é uma valvulopatia de evolução lenta e insidiosa podendo o paciente manter-se assintomático por longo período de tempo. A disfunção sistólica induzida pelo esforço ocorre durante a história natural da IAC estando relacionada com alterações nos componentes tanto da pré-carga quanto da pós-carga. Apresentamos o caso de uma paciente do género feminino, de 58 anos, com diagnóstico de IAC que referia queixa de dispneia progressiva com evolução de seis anos. O teste cardiopulmonar foi indicado com intuito de avaliar a capacidade funcional e mostrou platô das curvas de consumo de oxigénio e de pulso de oxigénio, sugerindo disfunção sistólica latente relacionada à insuficiência aórtica crônica; condição posteriormente confirmada pelo Doppler-ecocardiograma de estresse com esforço físico dinâmico. Keywords: Chronic aortic regurgitation, Cardiopulmonary exercise test, Left ventricular dysfunction, Palavras-chave: Insuficiência aórtica crônica, Teste cardiopulmonar, Disfunção ventricular esquerda
url	http://www.sciencedirect.com/science/article/pii/S0870255113000747
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Contribution of cardiopulmonary exercise testing to the identification of latent systolic dysfunction in chronic aortic regurgitation

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