前田 和夫

Kazuo MAEDA

新潟大学医学部第一内科

The 1st Department of Internal Medicine, Niigata University School of Medicine

キーワード : Pulsed Doppler echocardiography, Valvular regurgitation, Normal subject, Physiological regurgitation

The precise incidence and severity of valvular regurgitation and the significance of these findings were studied in one hundred and thirty healthy subjects using pulsed Doppler echocardiography. Valvular regurgitation was defined by the presence of turbulent (widely scattered and continuous) Doppler signals, and the severity of regurgitation was defined by the maximal distance of the turbulent flow.
1) In all subjects, the incidence of aortic regurgitation, mitral regurgitation, tricuspid regurgitation, and pulmonary regurgitation was 12%, 23%, 33%, and 39%, respectively.
2) The cases with valvular regurgitation in any of four valves increased with age, 39% in young subjects (18-39 yrs.), 50% in middle-aged subjects (40-64 yrs.), and 72% in elderly subjects (65-84 yrs.), for a 53.8% average. Although the incidence of regurgitation in mitral, tricuspid, and pulmonary valves increased with age, aortic regurgitation was seen in only the elderly subjects.
3) With regard to the severity of valvular regurgitation, a maximal regurgitant flow distance of more than 1 cm was not seen in any of the young subjects; that from 1 to 2 cm was seen in only one case of the middle-aged subjects and in several cases (from 5 to 20.5%) of the elderly subjects (for each valve). These results suggest that valvular regurgitation is common in normal subjects, and valvular regurgitation based on a maximal regurgitant flow distance of less than 1 cm in young and middle-aged subjects (except aortic regurgitation), and less than 2 cm in elderly subjects (of all four valves), is thought to be "physiological regurgitation", as determined through the use of pulsed Doppler echocardiography.