Acute effect of static exercise in patients with aortic regurgitation assessed by cardiovascular magnetic resonance: role of left ventricular remodelling

• Published in: European radiology 2017-04, Vol.27 (4), p.1424-1430
• Main Authors: Alegret, Josep M., Martinez-Micaelo, Neus, La Gerche, Andre, Franco-Bonafonte, Luis, Rubio-Pérez, Francisco, Calvo, Nahum, Montero, Manuel
• Format: Article
• Language: English
• Subjects: Adult; Aortic Valve - diagnostic imaging; Aortic Valve - physiopathology; Aortic Valve Insufficiency - diagnostic imaging; Aortic Valve Insufficiency - physiopathology; Blood pressure; Cardiac; Diagnostic Radiology; Doppler effect; Ejection fraction; Exercise - physiology; Female; Heart rate; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Imaging; Internal Medicine; Interventional Radiology; Magnetic Resonance Spectroscopy - methods; Male; Medicine; Medicine & Public Health; Neuroradiology; Prospective Studies; Radiology; Rest; Ultrasound; Ventricular Remodeling - physiology; Volumetric analysis
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-016-4520-2

Objective In patients with aortic regurgitation (AR), the effect of static exercise (SE) on global ventricular function and AR severity has not been previously studied. Methods Resting and SE cardiovascular magnetic resonance (CMR) were prospectively performed in 23 asymptomatic patients with AR. Results During SE, we observed a decrease in regurgitant volume in both end-diastolic (EDV) and end-systolic (ESV) volume in both ventricles, as well as a slight decrease in LV ejection fraction (EF). Interestingly, responses varied depending on the degree of LV remodelling. Among patients with a greater degree of LV remodelling, we observed a decrease in LVEF (56 ± 4 % at rest vs 48 ± 7 % during SE, p  = 0.001) as a result of a lower decrease in LVESV (with respect to LVEDV. Among patients with a lower degree of LV remodelling, LVEF remained unchanged. RVEF remained unchanged in both groups. Conclusions In patients with AR, SE provoked a reduction in preload, LV stroke volume, and regurgitant volume. In those patients with higher LV remodelling, we observed a decrease in LVEF, suggesting a lower LV contractile reserve. Key points • In patients with aortic regurgitation , static exercise reduced preload volume . • In patients with aortic regurgitation , static exercise reduced stroke volume . • In patients with aortic regurgitation , static exercise reduced regurgitant volume . • In patients with greater remodelling , static exercise unmasked a lower contractile reserve . • Effect of static exercise on aortic regurgitation was assessed by cardiac MR .