Hemodynamic changes at rest and during exercise in patients with aortic stenosis of varying severity

Abstract

Hemodynamic studies and estimations of heart volume and work capacity were carried out in 34 patients with “pure” aortic stenosis and the findings were correlated to the degree of stenosis estimated by the calculated valve area. In a majority of patients with mild stenosis (Group I) and moderate stenosis (Group II), cardiac output, stroke volume, heart volume, pulmonary vascular resistance, and work capacity were “normal.” However, in patients with severe stenosis (Group III), cardiac output and stroke volume were significantly decreased, heart volume and pulmonary vascular resistance were increased, and the left ventricular function assessed by the LVEDP and stroke work or the coefficient of the stroke volume and heart volume was depressed. The exercise tolerance was markedly decreased in Group III due to symptoms of anginal pain or dyspnea. In those patients, the LVEDP was markedly elevated. The LVSP and LVEDP showed a positive correlation at rest and during exercise. The LVEDP and LVSP increased during exercise in most patients.