Follow-up studies in chronic aortic insufficiency
Klepzig, H.; Standke, R.; Baum, R.; Kunkel, B.; Maul, F.D.; Hör, G.; Kaltenbach, M.
Zeitschrift für Kardiologie 74(6): 348-352
1985
ISSN/ISBN: 0300-5860 PMID: 4024685 Document Number: 267168
In order to study the course of chronic aortic regurgitation 17 patients with various degrees of aortic valve incompetence were investigated twice with a time interval of 1.5 +/- 0.4 years. The following parameters were evaluated: NYHA class; electrocardiographic sum of the largest R-wave in V4-V6 plus the largest S-wave in V1-V3 (RS index); echocardiographic left ventricular end-diastolic diameter (EDD); roentgenographic heart volume (HV); scintigraphic left ventricular end-diastolic volume (EDV), regurgitated blood volume (RBV) and ejection fraction (EF). During the period of observation functional deterioration occurred in 5 cases, all suffering from moderate to severe aortic regurgitation. While EF did not change significantly (55 +/- 12% vs. 55 +/- 11%), all other parameters showed a significant increase: RS index 5.4 +/- 1.4 mVolt to 6.0 +/- 1.7 mVolt (p less than 0.01); EDD 6.3 +/- 0.7 to 6.8 +/- 0.9 cm (p less than 0.001); HV 1017 +/- 151 ml to 1099 +/- 261 ml (p less than 0.01); EDV 371 +/- 131 ml to 441 +/- 175 ml (p less than 0.001); RBV 117 +/- 57 ml to 151 +/- 77 ml (p less than 0.001). Cases with functional deterioration showed a higher initial EDV and EDD (487 +/- 143 vs. 322 +/- 93 ml, p less than 0.05; 7.1 +/- 0.7 vs. 6.1 +/- 0.5 cm, p less than 0.01). The increase of HV, EDV and RBV during the time of observation was higher than in the remaining patients (166 +/- 137 vs. 39 +/- 95 ml, p less than 0.05; 133 +/- 75 vs. 44 +/- 29 ml, p less than 0.01; 66 +/- 22 vs. 22 +/- 31 ml, p less than 0.01). On average it was less pronounced in cases with mild initial left ventricular dilation than in those with marked dilation.