EXERCISE RESPONSE IN ASYMPTOMATIC AORTIC STENOSIS

有症状的主动脉狭窄患者的劳累症状一直是 归因于运动血流动力学异常。为了评估锻炼 11例无症状主动脉瓣狭窄患者的血流动力学研究 (超声心动图瓣膜梯度+-31毫米汞柱)接受症状性限制性运动 (Bruce方案)，并进行动脉内血压监测。休息和 最大收缩压，预测最大血氧百分比 消耗，预测最大02脉搏的百分比(中风的指标 体积)、运动持续时间、年龄和最大心率与25 年龄分布相近的对照。与控件相比， 无症状的主动脉狭窄患者的收缩压较低 压力，预测耗氧量的较低百分比，以及较低的 预测的氧气脉搏的百分比。除了一名患者外，所有患者都因为 疲劳；剩下的病人主诉头晕。没有病人 出现运动性低血压。因此，主动脉瓣狭窄患者表现为 直立运动的血流动力学反应受损，即使在没有症状时也是如此。

Exertional symptoms in symptomatic patients with aortic stenosis have been attributed to abnormal exercise hemodynamics. In order to assess exercise hemodynamics in asymptomatic patients with aortic stenosis, 11 patients (valve gradient 64+-31 mmHg by Doppler) underwent symptom limited exercise (Bruce protocol) with intraarterial blood pressure monitoring. Rest and maximum systolic blood pressure, percent of predicted maximum oxygen consumption, percent of predicted maximum 02 pulse (an index of stroke volume), exercise duration, age, and maximum heart rate were compared to 25 controls of similar age distribution. Compared to the controls, the asymptomatic patients with aortic stenosis achieved a lower systolic blood pressure, a lower percent of predicted oxygen consumption, and a lower percent of predicted oxygen pulse. All but one patient stopped because of fatigue; the remaining patient complained of lightheadedness. No patient developed exercise-induced hypotension. Thus, aortic stenosis patients show impaired hemodynamic responses to upright exercise, even when asymptomatic.