The effect of exercise upon the mean systolic left ventricularbrachial artery gradient in aortic stenosis.

The purpose of this study is to determine the effects of variations in cardiac output upon the mean systolic left ventricular-brachial artery gradient in patients with aortic stenosis. The magnitude of this gradient varies with valve size, flow across the valve and possibly heart rate. The effect of these parameters has been investigated in patients with mitral stenosis. " 2 Since exertional dyspnea, angina and syncope are common in physiologically significant aortic stenosis, determination of the exercise aortic gradient is of considerable interest in evaluation of the mechanism of these symptoms. In principle, exercise gradient changes may result from alterations in left ventricular systolic pressure, brachial artery systolic pressure, or both factors.