守田 武志¹, 馬本 郁男³, 玉垣 栄², 平田 俊幸², 奥 成聡², 高松 一², 木谷 輝夫²

Takeshi MORITA¹, Ikuo UMAMOTO³, Sakae TAMAGAKI², Toshiyuki HIRATA², Naritoshi OKU², Hajime TAKAMATSU², Teruo KITANI²

¹京都地域医療学際研究所附属病院臨床検査部, ²京都地域医療学際研究所附属病院内科, ³済生会京都府病院循環器内科

¹Depatrtment of Clinical Laboratory, Kyoto Interdisciplinary Institute Hospital of Community Medicine, ²Department of Internal Medicine, Kyoto Interdisciplinary Institute Hospital of Community Medicine, ³Department of Cardiology, Saiseikai Kyoto Hospital

キーワード : Atrial fibrillation, Congestive heart failure, Echocardiogram, Systolic aortic regurgitation

Atrial fibrillation with systolic aortic regurgitation (Sys-AR) appeared in a case of congestive heart failure and disappeared when it improved. A 73-year-old woman known to have atrial fibrillation and valvular disease was hospitalized when her condition was diagnosis as congestive heart failure. The echocardiogram showed slight increase in left-atrial and left-ventricular diastolic dimensions, decrease in fractional shortening, grade 3/4 mitral regurgitation, and grade 2/4 aortic regurgitation. Doppler ejection flow signal at the outflow tract of the left ventricle was absent in cardiac cycles with a prominent shortening in the preceding R-R interval (PI), and aortic regurgitation was observed during diastole as well as subsequent systole. Seven days after admission, after improvement in congestive heart failure, the echocardiogram showed the Doppler ejection flow signal at the outflow tract of the left ventricle and no Sys-AR in cardiac cycles with prominent shortening in PI. We conclude that disappearance of Doppler ejection flow signal at the left ventricular outflow tract and the appearance of Sys-AR could result from systolic asynchrony in the ventricular septum associated with congestive heart failure.