Stress Testing in Asymptomatic Aortic Stenosis

Björn Redfors; Philippe Pibarot; Linda D Gillam; Daniel Burkhoff; Jeroen J Bax; Brian R Lindman; Robert O Bonow; Patrick T O'Gara; Martin B Leon; Philippe Généreux

doi:10.1161/CIRCULATIONAHA.116.025457

Stress Testing in Asymptomatic Aortic Stenosis

Circulation. 2017 May 16;135(20):1956-1976. doi: 10.1161/CIRCULATIONAHA.116.025457.

Affiliations

¹ From Clinical Trials Center, Cardiovascular Research Foundation, New York (B.R., D.B., M.B.L., P.G.); Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); Pulmonary Hypertension and Vascular Biology Research Group, Laval University, Québec, Canada (P.P.); Gagnon Cardiovascular Institute, Morristown Medical Center, NJ (L.D.G., P.G.); Columbia University Medical Center, New York (D.B., M.B.L., P.G.); Leiden University Medical Center, The Netherlands (J.J.B.); Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN (B.R.L.); Northwestern University Feinberg School of Medicine, Chicago, IL (R.O.B.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.T.O.); and Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Québec, Canada (P.G.).
² From Clinical Trials Center, Cardiovascular Research Foundation, New York (B.R., D.B., M.B.L., P.G.); Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); Pulmonary Hypertension and Vascular Biology Research Group, Laval University, Québec, Canada (P.P.); Gagnon Cardiovascular Institute, Morristown Medical Center, NJ (L.D.G., P.G.); Columbia University Medical Center, New York (D.B., M.B.L., P.G.); Leiden University Medical Center, The Netherlands (J.J.B.); Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN (B.R.L.); Northwestern University Feinberg School of Medicine, Chicago, IL (R.O.B.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.T.O.); and Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Québec, Canada (P.G.). [email protected].

PMID: 28507251
DOI: 10.1161/CIRCULATIONAHA.116.025457

Abstract

Aortic stenosis is 1 of the most common heart valve diseases among adults. When symptoms develop, prognosis is poor, and current guidelines recommend prompt aortic valve replacement. Depending of the severity of the aortic stenosis and the presence of concomitant heart disease and medical comorbidities, stress testing represents a reasonable strategy to help better risk stratify asymptomatic patients. The present report provides a comprehensive review of the current available data on stress testing in aortic stenosis and subsequently summarizes its potential for guiding the optimal timing of aortic valve replacement.

Keywords: aortic stenosis; aortic valve; aortic valve replacement; exercise test; prognosis; stress test.

Publication types

Review

MeSH terms

Aortic Valve Stenosis / diagnosis*
Aortic Valve Stenosis / physiopathology
Aortic Valve Stenosis / therapy
Asymptomatic Diseases* / therapy
Clinical Decision-Making / methods*
Exercise Test / methods*
Humans