Doppler Echocardiographic Assessment of Progression of Aortic Regurgitation
Section snippets
Patient Population
A total of 127 consecutive patients with AR studied by 2-dimensional echocardiography and Doppler color flow mapping in our laboratory since 1988 were included. Patients ≥14 years old with AR who had ≥2 echocardiographic studies with a follow-up ≥6 months were selected. Patients with trace AR,[6]aortic gradient >20 mm Hg, aortic valve replacement after a short follow-up (<6 months), mitral prosthesis, mitral regurgitation (more than mild), congenital heart disease (except bicuspid aortic
Patient Characteristics at Entry
A total of 127 patients were studied (69 men; 59 ± 21 years; range 14 to 94). The follow-up interval was 21 ± 11 months (range 6 to 47) and was similar in patients with mild, moderate, and severe AR (20 ± 12, 21 ± 11, and 23 ± 11 months, respectively). Bicuspid aortic valves were diagnosed in 21 patients and rheumatic heart disease in 10; otherwise, etiologic diagnosis was not evident. Fig. 1 displays the number of patients in each branch of the AR grade algorithm. Since the subsets of patients
Discussion
This study reports on the largest number of patients to date with chronic AR followed by 2-dimensional echocardiography, and is the first to analyze the progression of AR by color Doppler. It provides: (1) the rate of progression of regurgitation; (2) differences in LV size and function among patients with different degrees of AR; (3) changes in LV size and function during the follow-up in patients with the various degrees of AR; and (4) determinants of progression.
Acknowledgements
Luis R. Padial, MD, was a visiting Clinical and Research Fellow from the “Hospital Virgen de la Salud,” Toledo, Spain, supported by a grant from the “Fondo de Investigación Sanitaria” of the Ministry of Health of Spain, Madrid, Spain.
References (29)
- et al.
Predictors of outcome for aortic valve replacement in patients with aortic regurgitation and left ventricular dysfunction: a change in the measuring stick
J Am Coll Cardiol
(1987) - et al.
Preoperative left ventricular function: minimal requirement for successful late results of valve replacement for aortic regurgitation
J Am Coll Cardiol
(1987) - et al.
Prevalence of valvular regurgitation by Doppler echocardiography in patients with structurally normal hearts by two-dimensional echocardiography
Am Heart J
(1989) Left ventricular radius to wall thickness ratio
Am J Cardiol
(1979)- et al.
Relation of left ventricular shape, function, and wall stress in man
Am J Cardiol
(1974) - et al.
Accuracy of 2-dimensional echocardiographic diagnosis of congenitally bicupside aortic valve: echocardiographic-anatomic correlation in 115 patients
Am J Cardiol
(1983) - et al.
Evaluation of aortic insufficiency by Doppler color flow mapping
J Am Coll Cardiol
(1987) - et al.
Quantitation of aortic regurgitation by Doppler echocardiography: a practical approach
Am Heart J
(1995) - et al.
Quantitative evaluation of aortic insufficiency by continuous-wave Doppler echocardiography
J Am Coll Cardiol
(1986) - et al.
Quantification of aortic regurgitation utilizing continuous-wave Doppler ultrasound
J Am Coll Cardiol
(1986)
The JH/LVOH method in the quantification of aortic regurgitation: how the cardiac sonographer may avoid an important potential pitfall
J Am Soc Echo
Aortic valve morphology: an important in vitro determinant of proximal regurgitant jet width by Doppler color mapping
J Am Coll Cardiol
Idiopathic degeneration of the aortic valve: a common cause of isolated aortic regurgitation
J Am Coll Cardiol
Long term nifedipine unloading therapy in asymptomatic patients with chronic severe aortic regurgitation
J Am Coll Cardiol
Cited by (28)
Epidemiology of acquired valvular heart disease
2014, Canadian Journal of CardiologyCitation Excerpt :A progression of at least 1 grade was reported in 50% of patients with moderate to severe AR and only 25% in those with mild AR, after a mean follow-up of 21 months.42 The progression is more rapid in BAV and slower in rheumatic AR.42 Long-term survival depends on the severity of AR and its consequences on the left ventricle.
Aortic Regurgitation
2009, Valvular Heart Disease: A Companion to Braunwalds Heart Disease Expert Consult - Online and PrintQuantification of Valvular Regurgitation
2008, Practice of Clinical Echocardiography, Thrid EditionEchocardiographic anatomy of ascending aorta dilatation: Correlations with aortic valve morphology and function
2006, International Journal of CardiologyAortic dimensions in patients with bicuspid aortic valve without significant valve dysfunction
2005, American Journal of CardiologyPure aortic regurgitation of the adult
2004, EMC - Cardiologie-Angeiologie