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Heart valve disease (aortic valve disease): aortic regurgitation 

Heart valve disease (aortic valve disease): aortic regurgitation
Heart valve disease (aortic valve disease): aortic regurgitation

Christophe Tribouilloy

, Patrizio Lancellotti

, Ferande Peters

, José Juan Gómez de Diego

, and Luc A. Pierard

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date: 05 July 2022

Echocardiography is the cornerstone examination for the assessment of aortic regurgitation (AR): it provides reliable evaluation of the aortic valve and allows diagnosis and identification of the mechanism of regurgitation. The specific aetiology of the disease can be identified in the majority of cases. A combination of quantitative and quantitative Doppler and two-dimensional (2D) echocardiographic parameters allows the evaluation of the severity of AR and determination of the haemodynamic and left ventricular function repercussions. Echocardiography allows the detection of associated lesions of the aortic root or other valves. In symptomatic patients, echocardiography is essential to confirm the severity of AR. In asymptomatic patients with moderate or severe AR, echocardiography is essential for regular follow-up, by providing precise and reproducible measurements of LV dimensions and function, and for identifying patients who should be considered for elective surgical intervention. In most cases, transthoracic echocardiography (TTE) provides all of the necessary information and transoesophageal echocardiography in usually not required. Real-time three-dimensional (3D) TTE can be complementary to 2D echocardiography for the assessment of the mechanism and quantification of AR by increasing the level of confidence, especially when 2D echocardiographic data are inconclusive or discordant with clinical findings. Tissue Doppler imaging and especially the speckle tracking method are promising approaches to detect early LV dysfunction in patients with asymptomatic severe AR. Echocardiography is therefore the key examination for the assessment of AR and at the centre of the strategic discussion concerning the indications and timing of surgery.

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