[Ultrasonic evaluation of chronic aortic regurgitation. Personal investigations]

Decision for valve replacement in valvular heart disease is actually based on non-invasive assessment without cardiac catheterization. This decision is particularly difficult in asymptomatic patients with aortic regurgitation (AR). Semiquantitative and quantitative assessment of the AR was performed in 74 pts aged 11-66, mean 34.9, 26 women, 48 men. M mode, 2D, Doppler PW, CW, color flow mapping in parasternal long, short axis, 4.5 CH and suprasternal view were obtained by Hewlett Packard Sonos 500 or 1000 with 3.5, 2.5 and 1.9 MHz transducer. LV internal diastolic diameter (LVIDD), stroke volume (SV) of the left and right ventricle, regurgitant fraction (RF), regurgitant volume (RV), regurgitant orifice (RO), LVEDP, deceleration slope, pressure half time (PHT) of regurgitant flow and proximal color flow regarding aortic valve diameter were calculated. The value of RF was 19-81%, mean 53 +/- 16% and correlated with SV (r = 0.72) Relation of the RF and LVEDP should be noticed. Positive correlation with observed up to 20-25 mmHg LVEDP. Further increasing LVEDP caused decreasing of the RF. High LVEDP confined regurgitant volume, because of diminished aorta (Ao)-LV diastolic pressure gradient. Ao-LV diastolic gradient dynamics is a very important supplement of LVEDP assessment. Deceleration in this group was 147-805 cm/s2 mean 270 +/- 120. PHT 128-812 ms mean 270 +/- 161 and correlated well with LVEDP (r = 0.87 and r = 0.85). Proximal color width in parasternal long axis correlated with RF (r = 0.76) and RO (r = 0.77). LVIDD was 4.3-8.8 cm mean 6.2 cm correlated with LVEDP r = 0.60, PHT = -0.69.(ABSTRACT TRUNCATED AT 250 WORDS)