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The aim of this study is to determine the prognostic value of exercise stress echocardiography in patients with common valve lesions. One hundred and fifteen patients with VHD (aortic stenosis (<jats:italic>n<\/jats:italic>=28); aortic regurgitation (<jats:italic>n<\/jats:italic>=35); mitral regurgitation, (<jats:italic>n<\/jats:italic>=26); mitral stenosis (<jats:italic>n<\/jats:italic>=26)), and age- and sex-matched controls (<jats:italic>n<\/jats:italic>=39) with normal ejection fraction underwent exercise stress echocardiography. The primary endpoint was a composite of death or hospitalization for heart failure. Asymptomatic VHD patients had lower exercise capacity than controls and 37% of patients achieved &lt;85% of their predicted metabolic equivalents (METS). There were three deaths and four hospital admissions, and 24 patients underwent surgery during follow-up. An abnormal stress echocardiogram (METS &lt;5, blood pressure rise &lt;20 mmHg, or pulmonary artery pressure post exercise &gt;60 mmHg) was associated with an increased risk of death or hospital admission (14% vs 1%, <jats:italic>P<\/jats:italic>&lt;0.0001). The assessment of contractile reserve did not offer additional predictive value. In conclusion, an abnormal stress echocardiogram is associated with death and hospitalization with heart failure at 2 years. Stress echocardiography should be considered as part of the routine follow-up of all asymptomatic patients with VHD.<\/jats:p>","DOI":"10.1530\/erp-15-0015","type":"journal-article","created":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T01:32:23Z","timestamp":1436232743000},"page":"89-98","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exercise stress echocardiography in patients with valvular heart disease"],"prefix":"10.1186","volume":"2","author":[{"given":"Vishal","family":"Sharma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Newby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph A. 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