Clinical significance of positive treadmill exercise test in patients with mitral stenosis

Purpose: This study sought to assess the clinical significance of an exercise stress test (EST) in symptomatic mitral stenosis (MS) patients with sinus rhythm. Methods: Data from 44 consecutive patients with symptomatic MS and sinus rhythm who underwent balloon mitral commissurotomy, a pre-procedural submaximal treadmill test, and coronary angiography were analyzed. Results: Only one patient had angiographically significant coronary artery disease (CAD), but with a negative EST. Ten (23.3%) had positive ESTs, but without angiographically significant CAD. The sensitivity, specificity, positive and negative predictive values of EST for CAD were 0%, 75%, 0% and 97.1%, respectively. There was no association between hemodynamic parameters and a positive EST. Conclusions: False-positive EST is very common in MS patients, and is not related to their hemodynamic characteristics.