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J Echocardiogr. 2010 Mar;8(1):7-13. doi: 10.1007/s12574-009-0028-y. Epub 2009 Nov 14.

Quantitative measurements of aortic valve coaptation by three-dimensional transesophageal echocardiography in patients with aortic regurgitation without primary leaflet disease.

Journal of echocardiography

Koichiro Imai, Nozomi Watanabe, Ken Saito, Akihiro Hayashida, Tomoko Maehama, Yoshinori Miyamoto, Takahiro Kawamoto, Yoji Neishi, Hiroyuki Okura, Kiyoshi Yoshida

Affiliations

  1. Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. [email protected].
  2. Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.

PMID: 27278539 DOI: 10.1007/s12574-009-0028-y

Abstract

BACKGROUND: Aortic regurgitation (AR) without primary leaflet disease (functional AR) is known to occur as a result of loss of coaptation due to sinotubular junction (STJ) dilatation. However, the characteristics of change in the aortic valve coaptation length (AVCL) in 3 cusps in patients with functional AR are, as yet, unclear. The aim of this study was to measure the AVCL in 3 cusps in patients with functional AR by three-dimensional transesophageal echocardiograph (3D TEE).

METHODS AND RESULTS: Thirteen patients with functional AR with or without aortic dilatation (trivial to mild AR [group A] and moderate to severe AR [group B]) and 7 controls without AR (group N) were examined. We measured the AVCL between the left coronary cusp (LCC) and right coronary cusp (RCC), the LCC and non coronary cusp (NCC), the RCC and NCC, and we also measured the cusp projection area, STJ arc length, leaflet tip-Valsalva wall distance and inter-commissural distance in each cusp by 3D TEE. The average AVCL was significantly shorter in group B than in groups N and A (P < 0.001). Particularly, in group B, there was a significant difference in AVCL in the 3 cusps (P = 0.043). Moreover, although there were no significant differences in the size of cusps in groups N and A, there was disproportion in the size of those cusps in group B with the largest in RCC.

CONCLUSION: Cusp enlargement was not uniform and was greatest in the RCC, and the loss of coaptation between the 3 cusps was also not uniform, with predominant reduction in the coaptation between the RCC and the other 2 cusps.

Keywords: Aortic valve coaptation; Functional aortic regurgitation; Three-dimensional echocardiography

References

  1. Circulation. 2005 Aug 30;112(9 Suppl):I458-62 - PubMed
  2. Am Heart J. 1997 Nov;134(5 Pt 1):814-21 - PubMed
  3. J Heart Valve Dis. 2003 Mar;12(2):186-96 - PubMed
  4. Circulation. 1976 Jul;54(1):102-8 - PubMed
  5. Circ Res. 1974 Dec;35(6):871-82 - PubMed
  6. J Thorac Cardiovasc Surg. 2004 Mar;127(3):645-53 - PubMed
  7. Cardiovasc Res. 1973 Jul;7(4):490-4 - PubMed
  8. Circulation. 2003 Jun 17;107(23 ):2876-9 - PubMed
  9. Circulation. 1993 Sep;88(3):1150-6 - PubMed
  10. J Am Soc Echocardiogr. 1990 Jul-Aug;3(4):316-9 - PubMed
  11. Circulation. 1995 Feb 1;91(3):734-40 - PubMed
  12. J Am Coll Cardiol. 2005 Mar 1;45(5):763-9 - PubMed
  13. Circulation. 1991 Mar;83(3):817-21 - PubMed
  14. Mayo Clin Proc. 1988 Jul;63(7):649-80 - PubMed
  15. Ann Thorac Surg. 1999 Sep;68(3):949-53; discussion 953-4 - PubMed
  16. Am J Hypertens. 2008 May;21(5):558-63 - PubMed
  17. J Thorac Cardiovasc Surg. 2005 Nov;130(5):1459-61 - PubMed
  18. Am Heart J. 1995 May;129(5):1014-20 - PubMed
  19. J Thorac Cardiovasc Surg. 1973 Apr;65(4):511-8 - PubMed
  20. J Am Soc Echocardiogr. 1992 Mar-Apr;5(2):187-94 - PubMed
  21. J Am Coll Cardiol. 1987 Apr;9(4):952-9 - PubMed
  22. J Am Coll Cardiol. 2006 Nov 21;48(10 ):2053-69 - PubMed

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