Asymptomatic severe aortic regurgitation in the young. Hemodynamic and angiographic data in 37 patients with echocardiographic correlation.

The aim of this study was to evaluate from hemodynamic and angiocardiographic (ACG) data the extent of left ventricular (LV) systolic dysfunction in a group of predominantly young (mean age 29 years) asymptomatic patients with severe aortic regurgitation (AR). In addition, echocardiography was performed and these data were correlated with ACG data and the value of these parameters in predicting LV dysfunction was tested. Thirty-seven patients were catheterized and 18 demonstrated LV dysfunction with an ejection fraction (EF) of <50%. These patients were classified as group A and the remaining 19 patients with EF_??_50% formed group B. While there was no difference between the 2 groups with regard to age or regurgitant fraction, the end-diastolic pressure was raised (p<0.01) and cardiac index depressed (p<0.05)significantly in group A.Of the echocardiographic parameters, the end-systolic diameter(ESD) correlated best with the EF (coefficient of correlation=-0.7and p<0.001). In addition, the ESD was significantly higher in group A (p<0.001). When an ESD_??_48mm was used as a predictor of an EF<50% (group A) the sensitivity was 89% and the specificity 79%.In conclusion, many young asymptomatic patients with severe AR may have severe LV systolic dysfunction and an ESD_??_48mmis a good predictor of such a subgroup.