三木 隆彦, 横田 慶之, 野村 秀樹, 三木 隆, 江本 隆一, 黒住 泰明, 薄木 成一郎, 周 湘台, 福崎 恒

Takahiko MIKI, Yoshiyuki YOKOTA, Hideki NOMURA, Takashi MIKI, Ryuichi EMOTO, Hiroaki KUROZUMI, Seiichiro USUKI, Hsiang-Tai CHOU, Hisashi FUKUZAKI

神戸大学第一内科

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

キーワード : aortic regurgitation, regurgitant jet, reverse doming, 2-dimensional Doppler echocardiography

This study was performed to investigate the relation between reverse doming (RD) of anterior mitral leaflet and magnitude and direction of regurgitant jet in 26 patients with non-rheumatic aortic regurgitation using 2-dimensional (2-D) and 2-dimensional Doppler echocardiography (2-DD).
Direction of regurgitant jet was evaluated posteromedial, middle, or anterolateral side by short axis 2-DD and compared with the site of RD by short axis 2-D. The maximum area (A) of regurgitant jet, the angle (θ) between the center lines of regurgitant jet and ascending aorta, and A·sinθ were obtained from parasternal long axis 2-DD.
RD was observed in 7 patients (27%); 4 (57%) of 7 severe and 3 (18%) of 19 moderate aortic regurgitation patients. The site of RD observed by short axis 2-D was highly consistent with the direction of regurgitant jet by short axis 2-DD. The value of A was not different between patients with and without RD (8.0±3.1 cm² vs 5.7±2.4 cm²; ns). However, the values of θ and A·sinθ of patients with RD were significantly larger than those of patients without RD (39±7° vs 4±8°; p2 vs 0.4±0.6 cm²; pThus, the magnitude of regurgitant jet component toward the anterior mitral leaflet was the most causative factor for RD in patients with aortic regurgitation and the evaluation of regurgitant jet characteristics by 2-DD was useful for understanding the mitral valve motion in aortic regurgitation.