Prevalence of valvular regurgitation in structurally normal hearts: a colour-Doppler study

To evaluate, by colour-Doppler echocardiography, the effects of ageing on the continence of the heart valves in patients with normal hearts.

We reviewed all the consecutive echocardiographic examinations performed in our laboratory from 1988 to 1994. From a total of 4592 records, 1654 (977 from females and 677 from males) were selected as normal-that is, not having excluded any kind of valvular, chamber or wall pathology of the heart. These records alone were considered in the study.

One or more valve regurgitations were evident on 286 of the records (17.3%; 202 from females and 84 from males); regurgitation was always mild and was more frequent in females (20.7% compared with 12.4% of males; P < 0.001). Mitral regurgitation was the most frequent (49.3% of all regurgitant valves), followed by tricuspid, aortic and pulmonary. In age groups 0-17 years and > or = 60 years there was no sex difference in regurgitation. With ageing, there was an increasing trend in prevalence of regurgitation of the mitral, aortic and tricuspid valves in females (P < 0.001, P < 0.001 and P < 0.05, respectively), and of aortic and mitral valves in males (P < 0.001 for both). Multiple regurgitation (two or three valves) was not sex-dependent, but showed an increasing trend with ageing (from 13% to 27.5% of records showing regurgitation; positive trend, P < 0.005).

Prevalence of mild valvular regurgitation is age-dependent, but is more common in women than in men aged 18-59 years; there is no sex-related difference in patients aged 60 years or more.