747-1 Progression of Aortic Regurgitation Assessed by Doppler Echocardiography in 127 Patients: Degree of Regurgitation

To assess the progression of chronic aortic regurgitation (AR), 127 patients 169 men; 59 ± 21 yr) with AR (59 mild, 8 mild-to-moderate, 41 moderate, 4 moderate-to-severe, 15 severe) who had ≥ 6 months of follow-up (6–47 months) by color Doppler and 2-D echo were studied. The degree of AR was established at entry and follow-up studies using an algorithm (semi-quantitative) that takes into account several Doppler criteria (jet area and jet height ratios, jet length, pressure half-time, reversal of flow in descending aorta) and the jet height/LV outflow tract (LVOT) height ratio (quantitative). LV volume (Simpson) and LV mass (Devereux) were calculated. A significant increase in jet/LVOT height ratio was observed in the whole population (30 ± 17 vs. 35 ± 20%; p l 0.00001) and in the subsets of patients with mild (18 ± 7 vs. 22.3 ± 9%; p l 0.01), moderate (40 ± 14 vs. 44 ± 16%; p l 0.01) and severe (54 ± 19 vs. 65 ± 15%; p l 0.05) AR. An increase in the degree of AR (semi-quantitative) during the follow-up was observed in 38 (30%) of patients: 25% with mild, 37% with mild-to-moderate, 44% with moderate and 50% with moderate-to-severe AR (p l 0.006). Patients were further divided according to the rank order in the rate of progression of jet/LVOT height ratio into “progressives” (n = 18; rate g 5.64%/yr) and “non-progressives” (n = 109). Patients with “progressive” AR had a faster rate of progression of LV end-diastolic volume, LV end-systolic volume and LV mass than “non-progressives” (p l 0.025). Conclusions AR is a progressive disease even in patients with mild insufficiency. The progression in the degree of AR is more frequent in patients with more severe disease. The rate of progression of regurgitation appears to playa role in LV overload in patients with AR.