Velocity Vector Imaging in Patients With Moderate-to-Severe Aortic Regurgitation

Chronic aortic regurgitation (AR) is a progressive process which causes both left ventricular volume and pressure overload. While the volume overload is associated with the degree of the aortic regurgitant volume, the pressure overload occurs as a result of systemic hypertension developed due to increased stroke volume. In early stages, excentric hypertrophy occurs aiming to compensate the volume overload in the left ventricle. Therefore , ejection fraction remains in normal range despite the increasing volume overload. Left ventricular dilatation and impairment in ejection fraction only occur in the end stages of the disease. Asymptomatic patients with chronic aortic regurgitation (AR) have a good prognosis in the presence of preserved systolic function. Therefore it is a challenge to identify patients with subclinical left ventricular (LV) dysfunction. Velocity vector imaging (VVI) is a new echocardiographic method based on two dimensional gray scale imaging, which is angle independent and can provide more accurate data about cardiac function.

Inclusion criteria

• Moderate-to-severe aortic regurgitation identified by Standard echocardiography.
• Chronic isolated aortic regurgitation
• Being asymptomatic ( Class 1 according to NYHA)
• Sinusal rhythm

Exclusion criteria

• Ejection fraction < 50%
• Mitral valve disease accompanied to aortic regurgitation (patients with over mild degree of mitral regurgitation and stenosis
• Aortic stenosis
• Previous myocardial infarction, or the patients with >50% coronary occlusion in any of the coronary arteries.
• Cardiomyopathies
• AV conduction disorders
• Chronic renal or hepatic insufficiency
• Malignities