Decision Making With Imaging in Asymptomatic Aortic Regurgitation

被引:15
作者
Popovic, Zoran B. [1 ]
Desai, Milind Y. [1 ]
Griffin, Brian P. [1 ]
机构
[1] Cleveland Clin, Inst Heart & Vasc, Dept Cardiovasc Med, 9500 Euclid Ave,Desk J1-5, Cleveland, OH 44195 USA
关键词
aortic regurgitation; echocardiography; imaging; MAGNETIC-RESONANCE; MYOCARDIAL STRUCTURE; VALVE-REPLACEMENT; ECHOCARDIOGRAPHY; QUANTIFICATION; SEVERITY; ACCURACY; DISEASE; DETERMINANTS; PERFORMANCE;
D O I
10.1016/j.jcmg.2018.05.027
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The authors review the optimal sequence of multimodality imaging studies in patients with chronic asymptomatic aortic regurgitation (AR). The initial questions in evaluating such patients are: 1) is AR severe; and 2) does it significantly impact the left ventricle? Although transthoracic echocardiography is usually able to answer these questions, a cardiovascular magnetic resonance imaging study might be necessary if the data from echocardiography are conflicting or inadequate. If AR is severe and the left ventricle is severely dilated, surgery is indicated. If AR is severe but the left ventricle is not significantly impacted, echocardiographic exercise testing might unmask symptoms. If aortopathy is suspected, cardiovascular magnetic resonance (in younger patients) or computed tomography (in older patients) is necessary. In cases where AR severity or mechanism are unclear and no additional tests are possible, or if there is a potential for aortic valve repair, transesophageal echocardiography is appropriate. Finally, it is good practice to define a follow-up plan with the patient and referring physician, with an explanation as to what can be expected in the future. (C) 2018 by the American College of Cardiology Foundation.
引用
收藏
页码:1499 / 1513
页数:15
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