Format

Send to

Choose Destination
J Am Soc Echocardiogr. 2003 Aug;16(8):850-7.

Echocardiographic and clinical characteristics of aortic regurgitation because of systemic vasculitis.

Author information

1
Division of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-1 Poongnap-dong, Songpa-ku, Seoul, 138-040 South Korea. jksong@www.amc.seoul.kr

Abstract

BACKGROUND:

Although systemic vasculitis has been described as one cause of aortic regurgitation (AR), clinical features of this disease entity have not been fully characterized.

METHODS:

The clinical data of 153 consecutive patients (103 male), who underwent open-heart operation to correct predominant AR from January 1990 to December 2000 were retrospectively analyzed.

RESULTS:

A total of 16 patients (10%) were found to have AR associated with systemic vasculitis; there were 9 patients with Takayasu's arteritis (TA) and 7 with Beh├žet's disease (BD). All patients with TA, but only 3 with BD, were female (P <.05). Echocardiography showed redundant motion of the elongated aortic cusp with the frequent periaortic echo-free space in BD, and characteristic motion limitation of thickened cusp with dilated and thickened aorta in TA. All patients with TA, but only 1 patient with BD, were given a diagnosis before operation (P <.05); the others underwent emergency operation to control acute AR of unknown etiology, and were given a correct diagnosis after detection of paravalvular leakage. In TA, paravalvular leakage developed in 1 patient (11%) and another died suddenly with chest pain. In BD, paravalvular leakage developed in 6 patients (86%) who needed repeated operation, and 2 died even after the third operation. The 2-year survival without clinical events (paravalvular leakage, repeated operation, or death) was 76 +/- 15% in TA and 14 +/- 13% in BD (P <.05).

CONCLUSIONS:

TA and BD are 2 important causes of AR, and show different clinical features. A high rate of paravalvular leakage, especially in BD, warrants cautious systemic evaluations for the cause of AR, and characteristic echocardiographic findings seem to be helpful in the differential diagnosis.

PMID:
12878994
DOI:
10.1067/S0894-7317(03)00406-1
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center