Valvular & structural heart disease
Prevalence, mechanisms, and prognostic impact of dynamic mitral regurgitation assessed by isometric handgrip exercise
Authors' conclusion
Handgrip exercise echocardiography provides important information regarding the dynamic nature of MR, exercise-induced changes in left ventricular function, and pulmonary circulation with subsequent consequences for further therapeutic decision making.
Study context
- Population
- Patients with at least mild mitral regurgitation (MR) undergoing echocardiography at rest and during handgrip exercise
- Participants
- 367 patients
- Exposure
- Degenerative MR (DegMR) vs functional MR (FMR)
- Outcome
- Prevalence, mechanisms and prognostic impact of exercise-induced changes in MR
Main finding
As reported in the abstract
Exercise-induced increase in MR by ≥1 grade
Observational data: associations, not effects.
Further findings
| Outcome | DegMR | FMR |
|---|---|---|
| Correlation of exercise-induced change in systolic pulmonary artery pressure with change in effective regurgitant orifice area | ||
| R | 0.456 | 0.326 |
| P | P < 0.001 | P < 0.001 |
LV stroke volume index during handgrip in patients with exercise-induced MR increase
- Reduced in FMR; maintained in DegMR
Exercise-induced pulmonary hypertension
- Patients with DegMR and FMR developing pulmonary hypertension during exercise
- 26%
Event rates with early mitral valve surgery/intervention (FMR) · follow-up
- Early mitral valve surgery/intervention independently associated with lower event rates in FMR (not in DegMR)
- 0.177 (0.027-0.643); P = 0.025
- Effect measure not named in abstract
Original publication
Prevalence, mechanisms, and prognostic impact of dynamic mitral regurgitation assessed by isometric handgrip exercise. Eur Heart J Cardiovasc Imaging. Published 23 September 2023. doi:10.
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