Clinical Applications of Exercise Stress Echocardiography
Most of the athletes evaluated in the previous study have been treated with beta blockers by their assistant physicians. We conducted an open-label, prospective, non-randomized study to provide proof of concept that exercise stress echocardiogram can be a guide to tailored treatment in athletes with positive screening and that develop IVG and mitral valve SAM on exertion. We evaluated 52 athletes that developed IVG and 35 (32 had exercise-related symptoms or positive exercise electrocardiography) repeated the exercise stress echocardiogram under treatment with ß blockers Thirty athletes (85%) showed improvement with a significant reduction of IVG and of the prevalence of SAM were shown (Figure 10). These changes were associated to a significant reduction in heart rate at peak exercise. We concluded that athletes with positive screening - mostly by symptoms - for sports practice and IVG on exertion, treatment with oral ß blockers prevented the occurrence of IVG and SAM or significantly reduced its magnitude.
(Enlarge Image)
Figure 10.
IVG in one athlete assessed before and during beta blocker therapy.
Exercise echocardiography provides a useful tool to identify athletes with positive screening and normal rest echocardiogram who may benefit from beta-blocker therapy. This has also been observed by other authors.
Monitoring the Use of Beta Blockers
Most of the athletes evaluated in the previous study have been treated with beta blockers by their assistant physicians. We conducted an open-label, prospective, non-randomized study to provide proof of concept that exercise stress echocardiogram can be a guide to tailored treatment in athletes with positive screening and that develop IVG and mitral valve SAM on exertion. We evaluated 52 athletes that developed IVG and 35 (32 had exercise-related symptoms or positive exercise electrocardiography) repeated the exercise stress echocardiogram under treatment with ß blockers Thirty athletes (85%) showed improvement with a significant reduction of IVG and of the prevalence of SAM were shown (Figure 10). These changes were associated to a significant reduction in heart rate at peak exercise. We concluded that athletes with positive screening - mostly by symptoms - for sports practice and IVG on exertion, treatment with oral ß blockers prevented the occurrence of IVG and SAM or significantly reduced its magnitude.
(Enlarge Image)
Figure 10.
IVG in one athlete assessed before and during beta blocker therapy.
Exercise echocardiography provides a useful tool to identify athletes with positive screening and normal rest echocardiogram who may benefit from beta-blocker therapy. This has also been observed by other authors.
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