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Med Arch. 2010; 64(5): 269-273


The Role of Exercise Test in Stratifying the Risk of Asymptomatic Patients with Moderate/Severe Aortic Stenosis

Zumreta,Kusljugic,,Fahir,Barakovic,,Mirza,Dilic,,Larisa,Dizdarevic-Hudic,,Elnur,Smajic,,Jasmin,Caluk,,Sevleta,Avdic,,Suada,Mulic,,Maida Isabegovic,,Melika,Avdagic,,Katarina,Kovacevic-Divkovic,,Amira,Bijedic.

Abstract
Objectives: The role of exercise test in risk stratifying of asymptomaticpatients with moderate and severe aortic stenosis (AS) in recentliterature is still controversial. The aim of this study was to evaluatethe role of exercise test in stratifying the risk of patients with moderate tosevere aortic stenosis. Methods: At the Internal Medicine Clinic, Departmentof Cardiology in Tuzla, in the period from January 2008 until January 2010was followed 33 patients with clinical and echocardiographic parametersof moderate to severe asymptomatic aortic stenosis (mean effective orificearea EOA 0,90,34 cm2). In statistical analysis we used descriptive statistics,t-test, chi-square test and Kaplan-Meier life table for predictive values, sensitivityand specificity. A significance level of 0.05 was used. Results: Twopatients were excluded due to exclusion criteria, so 31 patient was followedup during 12 months period. Eighteen patients (58%) with EOA Ł 0,8cm2had limiting symptoms during the test. During follow-up period, 11 patientsdeveloped serious spontaneous symptoms, and out of them 8 patients underwentsurgical valve replacement, one patient died (sudden cardiac death),and 2 patients had serious complications (ischemic cerebral stroke). Twentypatients remained asymptomatic. The highest positive predictive accuracyhad EOAŁ 0,8cm2 with limiting symptoms and it was 85%. The highestnegative predictive accuracy had ST depression. Conclusion: only limitingsymptoms along with EOAŁ 0,8cm2 had positive predictive accuracy.

Key words: asymptomatic aortic stenosis, exercise test, prognosis



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