Exercise behavior of degenerative mitral stenosis
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ORIGINAL PAPER
Exercise behavior of degenerative mitral stenosis Benjamin Horn1 · Kevin Bryan Lo1 · Shantanu P. Sengupta2 · Gregg S. Pressman3,4 Received: 26 March 2020 / Accepted: 21 May 2020 © Springer Nature B.V. 2020
Abstract Mitral annular calcification (MAC) is increasingly encountered, particularly among the elderly and those with chronic kidney disease, and is often associated with a transvalvular gradient. In contrast to rheumatic mitral stenosis relatively little is known about mitral stenosis due to MAC. We aimed to clarify whether exercise limitation in this group is primarily due to valvular obstruction or ventricular dysfunction resulting from multiple comorbidities. 20 patients with severe MAC (bulky calcium deposits which restricted leaflet motion) were submitted to supine bicycle exercise, measuring Doppler and echocardiographic parameters at baseline and during exercise. They were compared 1:1 to subjects matched for age, sex, and left ventricular wall thickness. At baseline MAC subjects had higher mean mitral valve gradients (MVG) than comparison subjects (7.5 ± 3.8 vs 1.6 ± 0.8 mm Hg, p
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