[Echo parameters of chronic aortic regurgitation (author's transl)]

Staging and timing of aortic-valve replacement, with respect to long-term prognosis is crucial in patients with isolated chronic aortic regurgitation (AR). To compare angiographic and M-mode echocardiographic parameters we echoed 39 patients one day before cardiac catheterisation: The angiography was used to divide the collective into four grades (G I-G IV). End-diastolic volume (EDV), stroke volume (SV) and regurgitant volume (RV) were used as echo parameters of the left ventricular volume, ejection fraction (EF) and circumferential fiber shortening (VCF) as parameters of left ventricular function. AR of G II and G III could be differentiated by an increase of EDV from 145 +/- 28.2 to 304 +/- 33.5 ml (p < 0.001), whereas EDV in G I-G II were similar to normal and G IV was similar to G III. EF and VCF were able to differentiate G III and G IV by a decrease from 67 +/- 8% to 54 +/- 7% (p < 0.001) and 1.01 +/- 0.24 to 0.88 +/- 0.31 (p < 0.01) respectively. Thus echo measurements predicted AR greater than G II from an increase of the EDV by more than 110% and a regurgitant volume of more than 3 1/min. G III and G IV could be differentiated by EF und VCF. These quantitative echo parameters were highly sensitive (92%) and specific (96%) whereas all other M-mode echo signs (oscillations of the mitral valve leaflet and interventricular septum, amplitude of oscillations, aortic root diameter, diastolic separation of the cusps) could be used only as qualitative indices, some with high specificity. Echocardiography allows a non-invasive assessment of the severity of AR based on parameters of left ventricular volume and function and thereby assist the accurate timing of aortic valve replacement.