The Emerging Role of Exercise Testing and Stress Echocardiography in Valvular Heart Disease

Eugenio Picano, Philippe Pibarot, Patrizio Lancellotti, Jean Luc Monin, Robert O. Bonow*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

168 Scopus citations


Exercise testing has an established role in the evaluation of patients with valvular heart disease and can aid clinical decision making. Because symptoms may develop slowly and indolently in chronic valve diseases and are often not recognized by patients and their physicians, the symptomatic, blood pressure, and electrocardiographic responses to exercise can help identify patients who would benefit from early valve repair or replacement. In addition, stress echocardiography has emerged as an important component of stress testing in patients with valvular heart disease, with relevant established and potential applications. Stress echocardiography has the advantages of its wide availability, low cost, and versatility for the assessment of disease severity. The versatile applications of stress echocardiography can be tailored to the individual patient with aortic or mitral valve disease, both before and after valve replacement or repair. Hence, exercise-induced changes in valve hemodynamics, ventricular function, and pulmonary artery pressure, together with exercise capacity and symptomatic responses to exercise, provide the clinician with diagnostic and prognostic information that can contribute to subsequent clinical decisions. Nevertheless, there is a lack of convincing evidence that the results of stress echocardiography lead to clinical decisions that result in better outcomes, and therefore large-scale prospective randomized studies focusing on patient outcomes are needed in the future.

Original languageEnglish (US)
Pages (from-to)2251-2260
Number of pages10
JournalJournal of the American College of Cardiology
Issue number24
StatePublished - Dec 8 2009


  • echocardiography
  • exercise testing
  • stress echocardiography
  • valve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'The Emerging Role of Exercise Testing and Stress Echocardiography in Valvular Heart Disease'. Together they form a unique fingerprint.

Cite this