Abstract 15013: A Rise in Systolic Pulmonary Arterial Pressure at Low Level of Exercise Predicts Prognosis in Asymptomatic Patients With Organic Mitral Regurgitation -Results From the PROGRAM Study

Introduction: The optimal timing of mitral valve surgery in asymptomatic patients with chronic severe organic mitral regurgitation (MR) is controversial. Exercise-induced pulmonary arterial hypertension (systolic pulmonary arterial pressure [SPAP] > 60 mmHg) has been shown to predict cardiac events. Hypothesis: The objective of this study was to examine the prognostic value of the increase in the SPAP during the early phase of the exercise test in asymptomatic organic MR. Methods: A total of 133 patients (age=61±14 years; 53% men) with at least a moderate asymptomatic MR who were not candidate for surgery were prospectively recruited in the PROGRAM study from 2008 to 2016. Doppler-Echocardiography was performed at rest and during a semi-supine bicycle exercise using a stepwise protocol with 25 Watt increments. Peak VO2 was measured during a separate treadmill exercise. SPAP was determined at each stage of exercise by measuring the peak systolic gradient of tricuspid regurgitation. The change in SPAP (ΔSPA...