{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T19:24:03Z","timestamp":1784748243376,"version":"3.55.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The prognostic value of serial exercise echocardiography (EEC) in asymptomatic severe aortic stenosis is unknown. We sought to evaluate the safety and utility of monitoring patients with asymptomatic severe aortic stenosis by annual EECs to refer them to aortic valve replacement (AVR) or to keep them under follow\u2010up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">The cohort comprised 196 patients, with a normal screening EEC and a minimal follow\u2010up of 18\u2009months. Follow\u2010up was planned until there was an indication for AVR, based on a resting transthoracic echocardiography at 6\u2009months and then every year, and an EEC at 1\u2009year and then every year (alternating resting transthoracic echocardiography and EEC every 6\u2009months). During follow\u2010up, patients were referred to AVR if they reported symptoms, if rest transthoracic echocardiography was positive (left ventricular dysfunction, aortic maximal velocity \u22655\u2009m\/s, or severe valve calcification with aortic maximal velocity progression \u22650.3\u2009m\/s per year) or if EEC was positive (occurrence during exercise of any aortic stenosis\u2010related symptoms, significant ventricular arrhythmias, a drop or an insufficient rise (&lt;20\u2009mm\u2009Hg) in systolic blood pressure from baseline, or a left ventricular dysfunction). Among the 196 patients (76% men, aged 76.1\u00b111.1\u2009years), a mean 2.85\u00b11.22 EECs were conducted. There were no serious complications during any of the EECs. Each serial transthoracic echocardiography at rest and each EEC yielded 0%\u201322% and 23.5%\u201350% of positive results, respectively, leading to AVR. We delayed AVR by a mean of 2.93\u00b11.95\u2009years after the screening EEC. No cardiac\u2010related death or sudden death was reported during the study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our findings demonstrate the safety and prognostic utility of serial EECs in the management of patients with asymptomatic severe aortic stenosis to guide timely AVR.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036599","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T11:21:31Z","timestamp":1734693691000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic Value and Safety of Serial Exercise Echocardiography in Asymptomatic Severe Aortic 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