Utility of stress Doppler echocardiography in patients undergoing percutaneous mitral balloon valvotomy

A subset of patients with mitral stenosis have symptoms out of proportion t o the resting hemodynamics, Exercise Doppler echocardiography Is a useful d iagnostic modality to determine which patients are limited by their valve o bstruction and would therefore benefit from percutaneous mitral balloon val votomy. We analyzed 11 patients who showed a peak exercise mean mitral grad ient that doubled from baseline or a final gradient of > 15 mm Hg. The mean mitral gradient increased from 7 +/- 2 nun Hg at rest to 19 +/- 6 mm Hg (P < .001) with exercise, All patients reported improvement in symptoms of at least 1 functional class after valvotomy.