Aortic Regurgitation

被引:30
作者
Flint, Nir [1 ,2 ]
Wunderlich, Nina C. [3 ]
Shmueli, Hezzy [1 ,2 ]
Ben-Zekry, Sagit [4 ]
Siegel, Robert J. [1 ]
Beigel, Roy [4 ]
机构
[1] Cedars Sinai Med Ctr, Smidt Heart Inst, Los Angeles, CA 90048 USA
[2] Tel Aviv Univ, Dept Cardiol, Sackler Fac Med, Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel
[3] Cardiovasc Ctr Darmstadt, Darmstadt, Germany
[4] Tel Aviv Univ, Sackler Sch Med, Leviev Heart Ctr, Sheba Med Ctr, Tel Aviv, Israel
关键词
Aortic regurgitation; Etiology; Diagnosis; Echocardiography; Treatment; Surgical therapy; TAVR; VALVULAR HEART-DISEASE; BETA-BLOCKER THERAPY; VALVE-REPLACEMENT; DOPPLER-ECHOCARDIOGRAPHY; NONINVASIVE EVALUATION; AMERICAN-SOCIETY; CORONARY FLOW; ORIFICE AREA; TASK-FORCE; QUANTIFICATION;
D O I
10.1007/s11886-019-1144-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of ReviewAortic regurgitation (AR) is a common form of valvular disease which is characterized by reflux of blood from the aorta into the left ventricle (LV) during diastole. AR results from various etiologies, affecting the aortic valve cusps or the aortic root. The clinical presentation of patients with AR depends on the severity of the regurgitation and differs whether AR develops acutely or if it progresses over a prolonged period, allowing the cardiac chambers to adapt. Echocardiography is the primary method to determine the etiology of AR and to define its severity. We review the current data regarding the diagnosis and treatment of AR.Recent FindingsNo single parameter is sufficient to determine AR severity; thus, an integrative, multi-parametric approach is required. Echocardiography is key for imaging the aortic valve morphology and flow as well as aortic root and ascending aorta. Determining LV ejection fraction and dimensions is essential for patient management and optimizing timing for intervention. Three-dimensional (3D) echocardiography is useful in the evaluation of AR etiology and severity. The use of Trasncatheter aortic valve replacement (TAVR) has emerged as an alternative to surgery in patients at high operative risk.SummaryThe diagnosis and management of AR requires a comprehensive approach and routine clinical and echocardiographic follow-up. Surgical or percutaneous therapy is indicated when symptoms develop and in those who have LV dysfunction or LV dilation.
引用
收藏
页数:12
相关论文
共 55 条
  • [21] WALL STRESS AND PATTERNS OF HYPERTROPHY IN HUMAN LEFT-VENTRICLE
    GROSSMAN, W
    JONES, D
    MCLAURIN, LP
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1975, 56 (01) : 56 - 64
  • [22] A prospective survey of patients with valvular heart disease in Europe:: The Euro Heart Survey on Valvular Heart Disease
    Iung, B
    Baron, G
    Butchart, EG
    Delahaye, F
    Gohlke-Bärwolf, C
    Levang, OW
    Tornos, P
    Vanoverschelde, JL
    Vermeer, F
    Boersma, E
    Ravaud, P
    Vahanian, A
    [J]. EUROPEAN HEART JOURNAL, 2003, 24 (13) : 1231 - 1243
  • [23] Repair of the Regurgitant Bicuspid or Tricuspid Aortic Valve: Background, Principles, and Outcomes
    Kari, Fabian A.
    Siepe, Matthias
    Sievers, Hans-Hinrich
    Beyersdorf, Friedhelm
    [J]. CIRCULATION, 2013, 128 (08) : 854 - 863
  • [24] Optimizing timing of surgical correction in patients with severe aortic regurgitation: Role of symptoms
    Klodas, E
    EnriquezSarano, M
    Tajik, AJ
    Mullany, CJ
    Bailey, KR
    Seward, JB
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 30 (03) : 746 - 752
  • [25] Determinants of the degree of functional aortic regurgitation in patients with anatomically normal aortic valve and ascending thoracic aorta aneurysm. Transoesophageal Doppler echocardiography study
    La Canna, G.
    Maisano, F.
    De Michele, L.
    Grimaldi, A.
    Grassi, F.
    Capritti, E.
    De Bonis, M.
    Alfieri, O.
    [J]. HEART, 2009, 95 (02) : 130 - 136
  • [26] QUANTITATIVE-EVALUATION OF AORTIC-INSUFFICIENCY BY CONTINUOUS WAVE DOPPLER ECHOCARDIOGRAPHY
    LABOVITZ, AJ
    FERRARA, RP
    KERN, MJ
    BRYG, RJ
    MROSEK, DG
    WILLIAMS, GA
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1986, 8 (06) : 1341 - 1347
  • [27] Vasoactive drugs in chronic regurgitant lesions of the mitral and aortic valves
    Levine, HJ
    Gaasch, WH
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1996, 28 (05) : 1083 - 1091
  • [28] Mann DL, 2015, Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine
  • [29] Surgical aortic valve replacement outcomes in the transcatheter era
    Martin, Elisabeth
    Dagenais, Francois
    Voisine, Pierre
    Dumont, Eric
    Charbonneau, Eric
    Baillot, Richard
    Kalavrouziotis, Dimitri
    Mohammadi, Siamak
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2015, 150 (06) : 1582 - 1588
  • [30] Nishimura RA, 2014, Circulation, V129, P521, DOI DOI 10.1161/CIR.0000000000000031