Symptom-limited, graded, bicycle exercise testing was performed with the patients in a semisupine position on a tilting exercise table. Beta-blockers were given neither on the day before the test nor on the morning of the test. After an initial workload of 25 W maintained for six minutes, the workload was increased every two minutes by 25 W. Every two minutes, blood pressure was measured and a 12-lead electrocardiogram was obtained. Two-dimensional and Doppler echocardiographic recordings were obtained throughout the test.
Conclusions: In patients with left ventricular systolic dysfunction, acute pulmonary edema is associated with the dynamic changes in ischemic mitral regurgitation and the resulting increase in pulmonary vascular pressure.
Estudo brilhante que analisou as mudanças na regurgitação mitral que provocam o edema pulmonar.
(During exercise, regurgitant volume and the effective regurgitant orifice area increased (by 26+/-14 ml and 16+/-10 mm(2)), respectively).