Is Exercise Testing Necessary to Assess Degenerative Mitral Regurgitation?

The value of exercise testing in characterizing functional mitral regurgitation (MR) is well established, but less is known about the importance of dynamic measures in degenerative MR. In this study, 61 patients with degenerative, asymptomatic MR (moderate or severe) underwent bicycle exercise echocardiographic evaluation.

Mean exercise duration was 8.9 minutes, and maximal heart rate achieved was 125 beats per minute. In the cohort as a whole, regurgitant volume (68–70 mL, as calculated with the proximal isovelocity surface area method) did not differ from baseline to peak exercise, although effective regurgitant orifice area increased slightly from 42 mm² to 45 mm². However, in 18 patients, mean regurgitant volume increased by ≥15 mL at pe…