Extent and determinants of pulmonary hypertension unmasked by handgrip exercise in patients with mitral regurgitation

Abstract Background Pulmonary hypertension (PH) is an established prognosticator in patients with mitral regurgitation (MR). However, a substantial proportion of MR presents without PH at rest but may develop during exercise. Previous studies already demonstrated the prevalence and prognostic impact bicycle Until now, there are no data on exercise assessed by handgrip Purpose To assess predictors exercise-induced MR. Methods We prospectively included least mild severity that underwent echocardiography three minutes according to standardized protocol. was defined systolic pulmonary artery pressure (SPAP) >50 mmHg. Results The final patient cohort 371 primary secondary Mean age 74±11 years, 48% were female 59% had atrial fibrillation. Median NT-proBNP 2017 (845–4976) ng/l. Thirty-eight percent MR, while 62% presented At rest, graded as 56% patients, moderate 32% severe 12%. SPAP 40±12 mmHg, 63 (17%) revealed (SPAP mmHg). Handgrip leads increase 7±12 Thus, 137 (37%) exhibited Together, 110 (32%) those showed Left- (OR 1.021 (1.010 1.033); p<0.001), right volume index 1.020 (1.009 1.035); RV fractional area change 0.972 (0.949 0.994); p=0.013), tricuspid 1.863 (1.434 2.445); p<0.001) 1.131 (1.100 1.167); PH. Moreover, linear correlation between effective regurgitant orifice (r=0.359; (r=0.370; SPAP. Patients more symptomatic NYHA functional class than (p=0.008) (Fig. 1). Conclusion(s) In unmasks every third rest. Bi-atrial dilatation, ventricular function, PH, changes correlate pressures. Funding Acknowledgement Type funding sources: Public Institution(s). Main source(s): This work supported Forschungskommission Medical Faculty Heinrich Heine University Düsseldorf Maximilian Spieker for Clinician Scientist Track.