Enhanced flow velocity increase through the left ventricular inflow tract of patients with isolated aortic regurgitation

Twenty-five patients with chronic aortic regurgitation (AR), and 12 control subjects were studied using Doppler echocardiography to investigate the effects of AR on transmitral flow. Peak early filling velocities at the levels of the mitral valve tips (E1) and annulus (E2) were measured, and the transmitral flow restriction index (ΔE = (E1 − E2)E2) was obtained. Patients with AR were classified into 2 groups according to the ratio of the crosssectional area of the regurgitant jet to that of the left ventricular outflow tract. Group I had the ratio < 0.20, and group II had ≥ 0.20. E2 in group II was lower than in control subjects, whereas E1 was not significantly different in any groups. ΔE in group II was higher than in group I or in control subjects (p < 0.05 and 0.01, respectively). ΔE showed a significant correlation with the crosssectional area ratio in all patients with AR (r = 0.70, p < 0.01) and in group II (r = 0.82; p < 0.01). Our data suggest that AR restricts early transmitral filling, and that AE may indicate the increased driving pressure caused by flow restriction and is a useful hemodynamic index of AR.