Aortic Regurgitation

Flint, Nir; Wunderlich, Nina; Shmueli, Hezzy; Ben‐Zekry, Sagit; Siegel, Robert J.; Beigel, Roy

doi:10.1007/s11886-019-1144-6

Cited by 34 publications

(44 citation statements)

References 53 publications

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“…Острая выраженная АР развивается в основном в результате резко возникшего поражения АК или аорты (наиболее часто -инфекционного эндокардита и острого расслоения аорты), травм или ятрогенных причин (например, чрескожных процедур на АК) [1,60]. Острая АР характеризуется внезапным увеличением конечно-диастолического объема (КДО) ЛЖ [1].…”

Section: остраяаортальнаярегургитацияunclassified

“…У больных с АР увеличены как давление ЛЖ (p), так и его радиус (r). Несмотря на то что увеличена толщина стенки (h), это не компенсирует комбинированное увеличение давления и радиуса ЛЖ [60,65]. Соответственно, существенное увеличение систолического напряжения стенок и постнагрузки ЛЖ при АР обусловливает возросшую потребность миокарда ЛЖ в кислороде [60].…”

Section: остраяаортальнаярегургитацияunclassified

“…Все отмеченные выше компенсаторные механизмы позволяют больным оставаться стабильными и не испытывать симптомы заболевания многие годы, даже при выраженной АР. Однако прогрессирующее состояние аортального порока и хроническая перегрузка объемом наряду с увеличенной постнагрузкой приводят к увеличению Л И Т Е р А Т у р А / R E F E R E N C E S конечно-систолического размера и, в конце концов, к снижению ФВ ЛЖ [60].…”

Section: остраяаортальнаярегургитацияunclassified

“…В дальнейшем сердечный выброс снижается, а КДД и КДО ЛЖ растут, обусловливая повышение как давления в левом предсердии, так и давления заклинивания легочной артерии, что может вызывать отек легких и увеличение значений давлений в легочной артерии, правых желудочке и предсердии. Состояние длительного повышения давления наполнения левых камер сердца может в конечном счете привести к правожелудочковой недостаточности [60]. заключение Таким образом, АР является довольно распространенным клапанным поражением сердца.…”

Section: остраяаортальнаярегургитацияunclassified

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Aortic regurgitation: epidemiologic, etiologic, and pathophysiologic characteristics

et al. 2021

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The presented review concerns aortic regurgitation which occupies a significant place in the structure of valvular heart disease. The detailed anatomic and physiologic description of the aortic valve is provided. The characteristics of sinotubular, ventricular-aortic junctions, and virtual aortic annulus are presented. There are data about prevalence of aortic regurgitation on the basis of results of population studies, indicating the increase in incidence of aortic regurgitation among individuals older 70–74 years. The detailed etiologic structure of this valvular pathology is described with specifying of the most common causes of both aortic disease and aortic cusps alterations. In particular, there are some aortic diseases, resulting in acute aortic regurgitation, including acute aortic dissection and paravalvular regurgitation in incompetence of the prosthetic aortic valve; in chronic one – idiopathic dilation of the aortic root, inherited connective tissue dysplasias (Ehlers–Danlos, Marfan, and Loeys–Dietz syndromes), bicuspid aortic valve, aortitis of various origin, seronegative arthropathies (reactive, psoriatic arthritis, ankylosing spondylitis) etc. Infective endocarditis and traumatic exposure are commonly responsible for development of acute regurgitation due to aortic cusps abnormalities. Chronic aortic regurgitation as a consequence valve defects occurs in rheumatic heart disease, degenerative changes, congenital anomalies, systemic connective tissue diseases (systemic lupus erythematosus, rheumatoid arthritis), non-specific aortoarteritis, etc. The special attention is paid to pathophysiologic features of acute and chronic aortic regurgitation in the review. Acute aortic regurgitation is characterized by sudden increase in end-diastolic volume and due to the noncompliant left ventricle of normal size, it undergoes abrupt exposure a significant pre-load and after-load which results in decrease of left ventricle systolic function and stroke volume despite on relative preservation of contractile function of myocardium. In contrast to acute aortic regurgitation it is remarkable in its chronic form slow, progressive influence by increased overload of the left ventricle with possibility to adapt driven by its gradual dilation and hypertrophy.

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Section: остраяаортальнаярегургитацияunclassified

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Aortic regurgitation: epidemiologic, etiologic, and pathophysiologic characteristics

et al. 2021

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“…In acute aortic regurgitation (AAR), retrograde blood flow may overwhelm the heart's ability to pump, leading to cardiac output collapse and retrograde congestion [3]. Patients may present with signs mimicking acute heart failure, including dyspnea, palpitations, syncope, and chest pain.…”

Section: Introductionmentioning

confidence: 99%

Intermittent Recovery of Severe Acute Aortic Regurgitation Arising From Infective Endocarditis

Cordeiro¹,

Trehan²,

Heaton³

et al. 2020

Cureus

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This case reports a 47-year-old male with a history of IV drug abuse, presenting with one week of left lower back pain. During the initial treatment, the patient became hemodynamically unstable, requiring vasopressor support. Transthoracic echocardiography (TTE) revealed a 1 cm x 1 cm aortic valve vegetation with severe aortic regurgitation and potential perforation of the valve leaflet. After hemodynamic stability was achieved, the patient left against medical advice, refusing urgent valvular surgery. Subsequent follow-up unveiled repeated recurrence of symptoms and surgical repair of the aortic valve.

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The advantages, pitfalls and limitations of guideline‐directed medical therapy in patients with valvular heart disease

Gill

Chehab

Allen

et al. 2021

European J of Heart Fail

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Heart failure is an inevitable end‐stage consequence of significant valvular heart disease (VHD) that is left untreated and increasingly encountered in an ageing society. Recent advances in transcatheter procedures and improved outcomes after valve surgery mean that intervention can (and should) be considered in all patients – even the elderly and those with multiple comorbidities ‐ at earlier stages of the natural history of primary VHD, before the onset of irreversible left ventricular dysfunction (and frequently before the onset of symptoms). All patients with known VHD should be monitored carefully in the setting of a heart valve clinic and those who meet guideline criteria for surgical or transcatheter intervention referred for intervention without delay. High quality evidence for the use of medical therapy in VHD is limited and achieving target doses in an elderly and comorbid population frequently challenging. Furthermore, determining whether the valve or ventricle is the principal disease driver is crucial (although the distinction is not always binary, and often unclear). Guideline‐directed medical therapy remains the mainstay of treatment for secondary mitral regurgitation ‐ although up to 50% of patients may fail to respond and should be considered for cardiac resynchronization, transcatheter or surgical valve intervention. Early and definitive management strategies are essential and should be overseen by a specialist Heart Team that includes a Heart Failure specialist. In this article, we provide an evidence‐based summary of approaches to the medical treatment of VHD and clinical guidance for the best management of patients in situations where high quality evidence is lacking.

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Aortic Regurgitation

Cited by 34 publications

References 53 publications

Aortic regurgitation: epidemiologic, etiologic, and pathophysiologic characteristics

Aortic regurgitation: epidemiologic, etiologic, and pathophysiologic characteristics

Intermittent Recovery of Severe Acute Aortic Regurgitation Arising From Infective Endocarditis

The advantages, pitfalls and limitations of guideline‐directed medical therapy in patients with valvular heart disease

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