0539: Value of the mean mitral gradient predictive of dyspnea in mitral stenosis in stress echo Doppler cardiac at peak effort

BackgroundIn stress echo Doppler cardiac of mitral stenosis (MS), the cut point of the mean mitral gradient (MMG) at the peak of the effort proposed by the American Recommendations for mitral dilation is 15mmHg. However, this value is questioned in the literatureObjectiveIn stress echo Doppler, determine the peak effort cutoff value of the MMG prediction of the occurrence of dyspnea justifying percutaneous mitral dilation in patients with MSMethodologyProspective descriptive study conducted in the Cardiology Department Hospital Beni Messous (Algiers) between March 2008 and December 2010. Have been included patients with mitral area ≤2 cm², functional class I to III NYHA and systolic pulmonary artery pressure ≤60mm Hg at rest. Dyspnea was sought to stress test on a treadmill (30W/3min). Dyspneic patients are those who have stopped the examination for a load ≤90W due to the occurrence of severe dyspnea. The stress echo Doppler was performed on table echocardiography (30W/3min). The MMG was measured at baseline and at the end of each level to the peak of the effortResultsThree hundred patients were included (mean age 42.3±1.3 years, 81.3% female). At the end of the stress test, 182 had dyspnea (60.6%). Areas under the curve of the MMG at peak stress is equal to 0.80, 95% confidence interval= 0.75-0.85 (p