Assessment of Coronay Blood Flow with Transesophageal Echocardiography in Aortic Regurgitation

Aortic regurgitation (AR) is a valvular heart disease resulting from defective diastolic closure of aortic valve. In this study, we tried to assess the coronary blood changes by transesophageal echocardiography in patients with AR. The study was performed in the Gülhane Military Medical Academy Cardiology Clinic. It involved 30 patients of whom 7 were female and 23 male (mean age: 24±8 years). The patients were divided into mild and severe AR groups. Ten free of cardiovascular disease according to history, physical, electrocardio graph i cal and echocardiographical examination were selected as the control group. The subjects underwent transthoracic (TTE) and subsequently transesophageal echocardiography {TEE) after appropriate history and physical examination. Left ventricular mass index was estimated by dividing transthoracic echocardiographically estimated left ventricular mass by boyd surface area. During TEE, pulsed Doppler flow video recordings were obtained from LAD just distally to the bifurcation. measurements were then obtained from these video recordings. Following parameters were obtained: mean and peak systolic flow velocities, mean and peak diastolic flow velocities, diastolic and systolic flow velocity integrals. Severity of AR was assessed by TTE from parastemal long axis view; when regurgitation jet was beyond the edge of anterior mitral leaflet, it was consideret as severe, otherwise as mild. For statistical comparisons, Mann-Whitney U test was used, p<0.05 being considered as significant. While there were no differences between the control group and the mild AR group with respect to any of the parameters, there were statistically significant differences between the severe AR group and btoh the mild AR group and the control group with respect to peak systolic flow velocity, peak diastolic flow velocity, mean systolic flow velocity, riıean diastolic flow vlocity, systolic velocity time integral, diastolic velocity time integral: LAD artery diameter. In severe AR group, flow/mass index ratio was significantly lower. ' In conclusion, in mild AR, coronary flow _patterns are s imilar to normal · subjects; but jn severe AR coronary flow increases though this increases though this increase is not sufficient to compensate eccentrically hypertrophied myocardial m~ss.