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Clinical events and echocardiographic lesion progression rate in subjects with mild or moderate aortic regurgitation

Sveeta Badiani1,2, Jet van Zalen1,2, Saad Saheecha1

  • 1East Sussex Healthcare NHS Trust, Eastbourne District General Hospital, East Sussex, UK

Echo Research and Practice
|June 15, 2017
PubMed

Insights

Progression of aortic regurgitation (AR) and clinical events are rare in patients with mild to moderate AR over medium-term follow-up. Isolated AR was associated with less progression compared to mixed valvular disease.

Area of Science:

  • Cardiology
  • Valvular Heart Disease
  • Echocardiography

Background:

  • The natural history and progression rate of aortic regurgitation (AR) are not well-defined.
  • Current guidelines recommend varying follow-up intervals for asymptomatic mild and moderate AR.
  • Systematic evaluation of AR progression in a defined patient cohort is needed.

Purpose of the Study:

  • To describe the clinical and lesion-based progression of mild and moderate aortic regurgitation.
  • To assess the incidence of clinical events in patients with mild to moderate AR.
  • To identify factors associated with AR progression.

Main Methods:

  • Retrospective analysis of 341 patients with mild or moderate aortic regurgitation.
  • Systematic clinical follow-up including assessment of aortic regurgitation progression.
  • Documentation of clinical events such as death, aortic valve replacement, and cardiac hospitalization.

Main Results:

  • Over a median follow-up of 4.6 years, 10% of patients showed AR progression, with 2.3% progressing to severe AR.
  • Clinical events were infrequent: 3 aortic valve replacements, 44 cardiac hospitalizations, and 9 deaths.
  • Patients with mixed valvular pathology had a higher rate of AR progression (15%) compared to isolated AR (5%).

Conclusions:

  • Progression of aortic regurgitation and significant clinical events are uncommon in patients with mild to moderate AR during medium-term follow-up.
  • Aortic regurgitation as an isolated valve pathology is associated with a lower likelihood of progression.
  • Systematic follow-up provides valuable data on the natural history of aortic regurgitation.

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