Echocardiographic Assessment of the Etiology of Aortic Regurgitation in the Elderly

Abstract

We performed echocardiographic studies in 189 elderly subjects aged over 65. Aortic regurgitation (AR) was detected by real time 2-D Doppler system. 189 patients were classified into 5 groups based on the severity of AR (AR-: 81 pts, AR1+: 32 pts, AR2+: 44 pts, AR3+: 27 pts, AR4+: 5 pts). The diameter of the aortic root, the angle (θ)between the aortic wall and interventricular septum and echo intensity of aortic valve were measured by 2-D echocardiography. There was no relation between the severity of AR and angle θ. Diameters of aortic root were significantly increased in AR3+ cases as compared with AR- and AR2+. Systolic blood pressure was significantly increased in AR4+ cases as compared with AR-, AR1+, and AR2+. Diastolic blood pressure was also decreased in AR3+ cases as compared with AR-. Echo intensity of aortic valve was increased in patients with AR. It was thought that increased diameters of the aortic root in patients with severe AR were induced from the long-standing AR, and that increased systolic blood pressure and decreased diastolic blood pressure in severe AR were caused by hemodynamic changes due to AR. Therefore, we concluded that AR in the elderly was caused by degeneration and/or deformity of the aortic valve.