{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:01:57Z","timestamp":1781730117126,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The assessment of aortic stenosis (AS) severity remains a challenge in some patients, and hemodynamic exercise testing has been proposed as a diagnostic tool in this population. However, the current understanding of exercise hemodynamics in AS is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of 34 adults (aged\u2009\u2265\u200918 years) with \u2265\u2009moderate AS and preserved left ventricular ejection fraction (LVEF) undergoing exercise invasive hemodynamics (supine cycle protocol) with simultaneous measurement of aortic and left ventricular pressures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Age was 77.1 (IQR 68.6; 84.1) years, and 50% were female. LVEF was 62.1\u2009\u00b1\u20096.6%. All patients were symptomatic. Resting aortic valve area (AVA) was 1.0\u2009\u00b1\u20090.2\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      and aortic valve (AV) systolic mean gradient 22.0\u2009\u00b1\u20097.3\u2009mmHg. At peak exercise (40 [IQR 30; 60] W), AV systolic mean gradient (\u03943 [0.6; 7] mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and AVA (\u03940.2 [0; 0.6] cm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) significantly increased, while stroke volume (SV) did not (\u03946.8\u2009\u00b1\u200919.4\u2009ml;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07). Exercise\u2010induced changes in AV systolic mean gradient were directly related to changes in cardiac output (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), being\u00a0inversely related to exercise systemic vascular resistance (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Elevated pulmonary artery wedge pressure was present in 41.2% at rest (\u2265\u200915\u2009mmHg) and 69.7% during exercise (\u2265\u200925\u2009mmHg).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Symptomatic patients with \u2265\u2009moderate AS and preserved LVEF experience small increases in AV mean gradient with exercise, and unlike the normal physiological response to exercise, there was no significant increase in SV. In most patients, AVA rose during exercise. Exercise\u2010induced elevation in filling pressures was highly prevalent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31511","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T05:51:21Z","timestamp":1744177881000},"page":"181-188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exercise Mildly Increases Transaortic Gradients in Aortic Stenosis With Preserved Ejection Fraction: An Invasive Hemodynamic Study"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9025-7453","authenticated-orcid":false,"given":"Abdullah","family":"Al\u2010Abcha","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1116-8541","authenticated-orcid":false,"given":"C. Charles","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick A.","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9465-8150","authenticated-orcid":false,"given":"Trevor J.","family":"Simard","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-5379","authenticated-orcid":false,"given":"Mackram F.","family":"Eleid","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota 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