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Age-related etiologies of aortic regurgitation with moderate or greater severity and coronary cusp bending: evaluation using transesophageal echocardiography

  • Original Article–Cardiology
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Abstract

Purpose

The prevalence of valvular heart disease has been rising, especially among those ≥ 65 years of age, because of age-related valvular degeneration resulting in an increase in the number of patients diagnosed with aortic regurgitation (AR). We analyzed transesophageal echocardiography (TEE) images in AR patients to identify the etiologies and investigate any differences in them according to age.

Methods

We studied 146 consecutive patients with chronic moderate or severe AR who underwent TEE. AR etiology was evaluated based on the TEE images in all the patients, as well as in each group separated by age.

Results

The total number of patients eligible was 126 (mean age 67 ± 12 years), consisting of an older group (n = 85, mean age 74 ± 5 years) and younger group (n = 41, mean age 52 ± 11 years). In total, the most common etiology of AR was cusp bending (33.0%). In the older group, it was the most frequent as well (48.2%), with the right coronary cusp being the most commonly affected site (90.2%). In the younger group, bicuspid aortic valve was the most common (36.5%). Subsequently, all the study subjects were re-classified into two groups according to the presence/absence of cusp bending. Multivariate analysis revealed that age was the only factor associated with cusp bending.

Conclusion

Cusp bending was the most frequent etiology of AR in the elderly. Preoperative detection of cusp bending by TEE would expand the therapeutic strategy for AR, including aortic valvuloplasty.

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Authors and Affiliations

  1. Department of Cardiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan

    Naoki Hoshino, Akira Yamada, Yuka Kawada, Meiko Hoshino, Sayuri Yamabe & Hideo Izawa

  2. Clinical Laboratory, Fujita Health University Hospital, Toyoake, Japan

    Kunihiko Sugimoto

  3. School of Health Sciences, Fujita Health University, Toyoake, Japan

    Kayoko Takada

Authors
  1. Naoki Hoshino
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  2. Akira Yamada
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  3. Yuka Kawada
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  4. Meiko Hoshino
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  5. Sayuri Yamabe
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  6. Kayoko Takada
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  7. Kunihiko Sugimoto
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  8. Hideo Izawa
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Correspondence to Akira Yamada.

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The authors declare that they have no conflicts of interest.

Ethical approval

The Institutional Ethics Committee approved the current retrospective evaluation of clinically acquired data and waived the need for patient written informed consent. The study conformed to the provisions of the Declaration of Helsinki.

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Hoshino, N., Yamada, A., Kawada, Y. et al. Age-related etiologies of aortic regurgitation with moderate or greater severity and coronary cusp bending: evaluation using transesophageal echocardiography. J Med Ultrasonics 49, 231–239 (2022). https://doi.org/10.1007/s10396-021-01177-0

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  • DOI: https://doi.org/10.1007/s10396-021-01177-0

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