Exercise test inaccurately identifies open heart surgery candidates, study

An internationally accepted exercise test often used to determine whether patients with a common cardiac disorder should undergo open heart surgery is highly inaccurate, according to a recent study published in the European Heart Journal.

Aortic stenosis — when the aortic heart valve narrows — obstructs blood flow and may cause a weakening of the heart. Severe cases require surgery to replace the valve. To help decide if surgery is necessary, patients are monitored while exercising on a stationary bike.

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For the study, researchers enrolled 174 patients across 10 institutions in the United Kingdom between 2012 and 2014. The participants were asymptomatic for the heart condition. Participants were assessed for aortic stenosis via the exercise test and monitored for the potential onset of symptoms. The test proved inaccurate. Of the 55 patients who had a positive exercise test, only 20 were found to later develop symptoms.

"Our findings showed that this exercise test, which has been approved by the American Heart Association/American College of Cardiology and the European Society of Cardiology, was highly inaccurate as almost twice the number of people who became breathless during the test did not develop symptoms within a year," said Gerry McCann, MD, professor of cardiac imaging at the University of Leicester in England.

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