Echocardiographic and hemodynamic features of severe aortic regurgitation with diastolic opening of the aortic valve

A Case of Severe Aortic Regurgitation Caused by Takayasu's Arteritis Showing End-Diastolic Opening of Aortic Valve

“…They also reported that premature closure of the mitral valve due to the rapid rise in LV diastolic pressure was the second notable finding in these settings. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 Consistent with these reports, we found signs of markedly elevated LV EDP suggested by the transmitral and pulmonary venous flow patterns along with late diastolic mitral regurgitation. In addition, we could further estimate the unique hemodynamics, relatively elevated mean left atrial pressure, and extremely elevated LV EDP from the continuous Doppler waveform of AR ( Figure 6 ).…”

“…Other conditions showing late diastolic opening of the AV were perforation of the leaflet secondary to infectious endocarditis, prolapse of the AV, and aortic dissection. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 However, this phenomenon has not been reported in Takayasu's arteritis, and ours is the first report of late diastolic opening of the AV due to AR in Takayasu's arteritis. Takayasu's arteritis is a large-vessel vasculitis that mainly affects the aorta and its branch, resulting in stenosis, occlusion, or dilation of the vessels, and the dilation of the aortic root occasionally causes AR.…”

“…As far as we know, diastolic opening of the AV in AR has been reported in 10 articles ( Table 1 ). 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 It was first reported by Page and Layton 1 in Marfan syndrome. Other conditions showing late diastolic opening of the AV were perforation of the leaflet secondary to infectious endocarditis, prolapse of the AV, and aortic dissection.…”

“…(1982) 6 Infective endocarditis Flail cusp 54 46 Martinez et al. (1986) 7 Marfan syndrome Aortic root dilation 63 60 Meyer et al. (1987) 8 Sinus of Valsalva aneurysm, syphilitic aneurysm Cusp prolapse 43–82 41–82 Shah et al.…”

“…Diastolic opening of the aortic valve (AV) in severe AR is an exceptionally rare phenomenon, which could be caused by equalization of LV EDP and systemic blood pressure due to severely elevated LV EDP. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 …”