Importance of the Diastolic Flow Reversal Parameters on Quantitation of Aortic Regurgitation

Abstract

Objective: Aortic regurgitation (AR) is one of the common cardiac valve diseases in the world. Grading the severity of chronic AR is quite critical. Despite the several clinical and echocardiographic data used, AR quantitation still remains challenging today. Findings obtained from the previous studies suggest that not only the duration of the retrograde flow but also the speed of the retrograde flow and diastolic velocity time integral (dVTI) may be associated with the AR grade. In our study, we aim to investigate the relationship and importance of the diastolic flow reversal parameters in the aorta with the grading of aortic regurgitation. Method: The study is designed as a single-center observational study for the evaluation of dVTI and end-diastolic flow velocity (EDFV) parameters in AR grading. A total of 93 patients were included in our study after exclusion criteria. Patients were divided according to the aortic regurgitation degree into three groups as mild (n ¼ 33), moderate (n ¼ 21), or severe (n ¼ 39). Echocardiographic acquisitions were done. Pulse wave velocity measurements were recorded in the descending aorta by positioning ultrasound rays parallel to the flow in the aorta and EDFV and dVTI parameters were determined. Result: According to echocardiographic measurements; between the groups; dVTI in the mild, moderate and severe AR groups were (8.5 6 2.4, 12.8 6 5.8, 17.4 6 6.2 cm, respectively, P < .001), and EDFV in the mild, moderate, and severe AR groups were (0.11 6 0.11, 0.10 6 0.11, and 0.24 6 0.13 m/s, respectively, P < .001), statistically significant different. Conclusion: In the light of the data obtained in our study, echocardiographic evaluation of the diastolic flow reversal profile in the descending aorta in patients with chronic AR and dVTI and EDFV measurements can contribute to AR grading