Value of exercise Doppler-echocardiography in patients with mitral stenosis

The value of exercise Doppler-echocardiography was studied in 60 patients with mitral valve stenosis. Patients were divided in three groups. In patients with a mitral valve area of more than 1.4 cm 2, maximal and mean diastolic gradient over the mitral valve increased from 13.2 ± 3.6 to 18.4 ± 5.4 and from 5.2 ± 1.9 to 8.8 ± 3.0 mmHg, respectively. In patients with a mitral valve area in between 1.0 and 1.4 cm 2, maximal and mean gradient increased from 19.0 ± 8.0 to 28.1 ± 8.9 and from 8.8 ± 4.9 to 14.8 ± 6.4 mmHg, respectively. In patients with a mitral valve area of less than 1 cm 2, the maximal gradient increased from 21.5 ± 5.8 to 34.2 ± 8.7 and mean gradient increased from 11.8 ± 4.1 to 20.3 ± 5.8 mmHg. Mean tricuspid regurgitation velocity increased from 2.9 ± 0.5 m/s to 3.6 ± 0.5 m/s, indicating increase in right ventricular to right atrial pressure difference from 34 mmHg to 52 mmHg. We conclude that exercise during the Doppler-echocardiographic evaluation provides additional information about the hemodynamic significance of mitral stenosis and can therefore be of value in decision making.