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Acute effect of static exercise in patients with aortic regurgitation assessed by cardiovascular magnetic resonance: role of left ventricular remodelling

  • Cardiac
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Abstract

Objective

In patients with aortic regurgitation (AR), the effect of static exercise (SE) on global ventricular function and AR severity has not been previously studied.

Methods

Resting and SE cardiovascular magnetic resonance (CMR) were prospectively performed in 23 asymptomatic patients with AR.

Results

During SE, we observed a decrease in regurgitant volume in both end-diastolic (EDV) and end-systolic (ESV) volume in both ventricles, as well as a slight decrease in LV ejection fraction (EF). Interestingly, responses varied depending on the degree of LV remodelling. Among patients with a greater degree of LV remodelling, we observed a decrease in LVEF (56 ± 4 % at rest vs 48 ± 7 % during SE, p = 0.001) as a result of a lower decrease in LVESV (with respect to LVEDV. Among patients with a lower degree of LV remodelling, LVEF remained unchanged. RVEF remained unchanged in both groups.

Conclusions

In patients with AR, SE provoked a reduction in preload, LV stroke volume, and regurgitant volume. In those patients with higher LV remodelling, we observed a decrease in LVEF, suggesting a lower LV contractile reserve.

Key points

• In patients with aortic regurgitation, static exercise reduced preload volume.

• In patients with aortic regurgitation, static exercise reduced stroke volume.

• In patients with aortic regurgitation, static exercise reduced regurgitant volume.

• In patients with greater remodelling, static exercise unmasked a lower contractile reserve.

• Effect of static exercise on aortic regurgitation was assessed by cardiac MR.

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Acknowledgments

The authors would like to acknowledge Maite Martín and Monique Mendoza for their invaluable technical support.

The scientific guarantor of this publication is Josep M Alegret, Hospital Universitari de Sant Joan, Reus (Spain). The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

This study has received funding by a grant from the Consejo Superior de Deportes, Government of Spain and by a grant from the Societat Catalana de Cardiologia.

One of the authors has significant statistical expertise.

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Authors and Affiliations

  1. Grup de Recerca Cardiovascular, Departments of Cardiology and Sports Medicine, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Av. del Dr. Josep Laporte 2, 43204, Reus, Spain

    Josep M. Alegret, Neus Martinez-Micaelo, Luis Franco-Bonafonte & Francisco Rubio-Pérez

  2. Baker IDI Heart and Diabetes Institute, Melbourne, Australia

    Andre La Gerche

  3. Department of Radiology, Hospital Universitari de Sant Joan, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain

    Nahum Calvo & Manuel Montero

Authors
  1. Josep M. Alegret
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  2. Neus Martinez-Micaelo
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  3. Andre La Gerche
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  4. Luis Franco-Bonafonte
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  5. Francisco Rubio-Pérez
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  6. Nahum Calvo
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  7. Manuel Montero
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Corresponding author

Correspondence to Josep M. Alegret.

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Alegret, J.M., Martinez-Micaelo, N., La Gerche, A. et al. Acute effect of static exercise in patients with aortic regurgitation assessed by cardiovascular magnetic resonance: role of left ventricular remodelling. Eur Radiol 27, 1424–1430 (2017). https://doi.org/10.1007/s00330-016-4520-2

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  • DOI: https://doi.org/10.1007/s00330-016-4520-2

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