IMR Press / RCM / Volume 25 / Issue 4 / DOI: 10.31083/j.rcm2504131
Open Access Review
Exercise Pulmonary Hypertension in Heart Valve Disease
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1 Cardiology and Intensive Coronary Care Unit, Fatebenefratelli Hospital, 80123 Naples, Italy
2 Cardio-Thoracic and Vascular Department, University Hospital “San Giovanni di Dio e Ruggid’Aragona”, 84131 Salerno, Italy
3 Cardiology IV, “A. De Gasperis” Department, Niguarda Ca' Granda Hospital, 20162 Milan, Italy
4 Unit of Cardiology, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
5 Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy
6 Department of Translational Medical Sciences, “Federico II” University, 80131 Naples, Italy
7 Gender Interdepartmental Institute of Research (Genesis), “Federico II” University, 80131 Naples, Italy
*Correspondence: (Alberto M. Marra)
These authors contributed equally.
Rev. Cardiovasc. Med. 2024, 25(4), 131;
Submitted: 24 October 2023 | Revised: 18 January 2024 | Accepted: 1 February 2024 | Published: 2 April 2024
(This article belongs to the Special Issue New Perspectives of Valvulopathy)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

The optimal management of heart valve disease (HVD) is still debated and many studies are underway to identify the best time to refer patients for the most appropriate treatment strategy (either conservative, surgical or transcatheter interventions). Exercise pulmonary hypertension (PH) can be detected during exercise stress echocardiography (ESE) and has been demonstrated to have an important prognostic role in HVD, by predicting symptoms and mortality. This review article aims to provide an overview on the prognostic role of exercise PH in valvulopathies, and its possible role in the diagnostic-therapeutic algorithm for the management of HVD.

heart valve diseases
exercise stress echocardiography
exercise pulmonary hypertension
right ventricle
right heart
Fig. 1.
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