Abstract 3558: Reduced Arterial Compliance in Patients with Aortic Regurgitation Increases Incidence of Holodiastolic Reversal Flow in Abdominal Aorta
Backgrounds: Holodiastolic reversal flow in the abdominal aorta has been commonly used as a simple index of severe aortic regurgitation (AR). However, normal diastolic reversal flow is often observed especially in advancing age. Accordingly, we attempted to evaluate the factors that influence the incidence of holodiastolic reversal flow in patients with mild or moderate AR.
Methods: Thirty seven patients (66±16 years old) with mild or moderate AR underwent echocardiography to assess severity of AR. Holodiastolic reversal flow was observed in 16 patients (R-AR) and were not in 21 patients (NR-AR). Regurgitant volume was quantified by PISA or pulsed Doppler methods, which greater than 60ml/beat was defined as severe AR. We also measured brachio-ankle pulse wave velocity (baPWV) as an index of arterial compliance.
Results: There were no significant difference in the regurgitant volume between R-AR and NR-AR (22.3±12.6 vs. 26.1±12.2 ml/beat, p=0.355). baPWV in R-AR was significantly faster than that in NR-AR (1894±308 vs. 1597±340 cm/sec, p=0.010). Multivariate logistic regression analysis demonstrated that baPWV (odds ratio 1.031 for every 10 cm/sec increase, 95% confidence intervals 1.007 to 1.065, p=0.027) but not regurgitant volume (p=0.509) significantly influenced on the existence of holodiastolic reversal flow.
Conclusions: Reduced arterial compliance increased the incidence of holodiastolic reversal flow in patients with mild or moderate AR. We need to pay careful attention to advancing arteriosclerosis not to overestimate the severity of aortic regurgitation.