Related Experiment Video
Updated: Sep 11, 2025

In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging
Published on: February 25, 2022
Aortic Regurgitation Jet Increases Left Ventricular Energy Loss Associated With the Progression of Cardiac Failure -
Shohei Yoshida1,2, Koichi Toda1, Yasushi Yoshikawa1
1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine.
Background:
Aortic valve regurgitation (AR) impairs cardiac function, but the underlying mechanisms remain unclear. Vector flow mapping (VFM) enables evaluation of blood flow patterns and energy loss in the left ventricle (LV). This study investigated the effect of AR on LV blood flow patterns, energy loss, and heart failure progression using VFM.
Methods And Results:
Forty patients with severe AR undergoing aortic valve replacement (AVR) between January 2016 and March 2018 were included. Echocardiogram-based VFM in apical long-axis and 4-chamber views was performed before and after AVR, with results compared to a control group without valvular diseases (n=21). Preoperative LV energy loss due to an AR jet was significantly higher in patients with AR (median 8.7 J; interquartile range [IQR] 5.7-13.3 J) than in controls (1.7 J; IQR 0.7-2.6 J; P<0.001), and was positively correlated with preoperative serum B-type natriuretic peptide (BNP) concentrations (P=0.029). LV energy loss was not associated with LV systolic function or regurgitant volume, but was significantly affected by AR jet direction. Postoperatively, after AVR, LV energy loss (median 2.0 J; IQR 1.5-2.7 J) decreased to the same level as in the control group.
Conclusions:
The regurgitant jet in severe AR increases LV energy loss, which is positively correlated with serum BNP concentrations, indicating that the AR jet contributes to the progression of heart failure through LV energy loss.
More Related Videos
Related Concept Videos
Aortic Regurgitation I: Introduction
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic Regurgitation III: Medical Management
Aortic Regurgitation IV: Nursing Management
Mitral Regurgitation I: Introduction
Mitral Stenosis I: Introduction

