Supine ergometry for aged population with degenerative mitral regurgitation: evidence for prognostic yield

Abstract Introduction Degenerative mitral regurgitation (MR) has an increased prevalence with aging risk stratification evolving as a complex scenario. Semisupine bicycle ergometry (SBE) is currently applied means to interrogate noninvasive hemodynamics. Aim of the study was prognostic parameters by SBE in asymptomatic moderate severe degenerative MR for patients older than 65 years. Patients and methods One hundred seventy-four (pts), followed up on valve clinic tertiary center (age 56/14 female 71), were referred SBE. related cardiac events (surgery, NYHA worsening) during follow 34/25 months occurred 24 pts. Age group >65 had 53 pts 71/4 vs 50/13 <0.001, females 36% 43%). The following (mean/SD) estimated at rest (R) (Ex): Biplane left ventricular (LV) ejection fraction (EF), stroke volume (SV), 2D LV strain (SR), tricuspid peak gradient (TRpg), transmitral E/e, HR, systolic blood pressure (SBP), HR*SBP product their respective % changes (%d). Results Group decreased workload (Watts: 74/22 89/18, p<0.001), similar achieved target heart rate (73/11 69/10), more symptoms (30% 16%, p<0.01). Event greater 7%, p<0.001). aged>65 differences SBPR (145/20 132/19, p<0.002), SREx (20/4 21/5, p<0.04), EFEx (64/9 68/6, p<0.01), TRpgR (34/11 27/6, TRPG Ex (55/13 50/10, p<0.02), E/eEx (14/6 11/3, p<0.006), %dSV (0.01/0.23 0.14/0.25, p<0.001) %dEF (0.12/0.08 0.15/0.11, p<0.03). In stepwise logistic regression analysis events, only selected (log exp 0.89, p<0.05). Classification ROC gave cut off 13 (area 0.67, p=0.01) sensitivity/specificity 50/80%. Kaplan Meier revealed contribution >13 age rank p<0.04, Figure 1). Moreover, symptomatic decisive aged cohort (Kaplan-Meier log = 0.004, 2). Conclusion may be efficient performance then years spectrum, within context MR, providing critical information Funding Acknowledgement Type funding sources: None.