Age-related etiologies of aortic regurgitation with moderate or greater severity and coronary cusp bending: evaluation using transesophageal echocardiography
Age-related etiologies of aortic regurgitation with moderate or greater severity and coronary cusp bending: evaluation using transesophageal echocardiography
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中度或以上严重程度的主动脉瓣反流和冠状动脉尖弯曲的年龄相关病因：经食管超声心动图评估
DOI：
10.1007/s10396-021-01177-0
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发表时间：
2022
影响因子：
1.8
通讯作者：
Izawa Hideo
中科院分区：
文献类型：
--
作者：
Hoshino Naoki;Yamada Akira;Kawada Yuka;Hoshino Meiko;Yamabe Sayuri;Takada Kayoko;Sugimoto Kunihiko;Izawa Hideo
目的：由于年龄相关性瓣膜变性导致主动脉瓣反流（AR）患者数量增加，瓣膜性心脏病的患病率一直在上升，尤其是在年龄≥65岁的人群中。我们分析了AR患者的经食管超声心动图（TEE）图像，以确定病因，并根据年龄调查其差异。方法我们研究了146例连续接受TEE治疗的慢性中重度AR患者。根据所有患者的TEE图像以及按年龄划分的每组评估AR病因。结果入选患者126例（平均年龄67±12岁），其中老年组85例（平均年龄74±5岁），年轻组41例（平均年龄52±11岁）。总的来说，AR最常见的病因是鼻尖弯曲（33.0%）。在老年组中，这也是最常见的（48.2%），右冠状动脉尖是最常见的受累部位（90.2%）。在年轻组中，二尖瓣主动脉瓣最常见（36.5%）。随后，所有的研究对象被重新分为两组根据是否有尖头弯曲。多因素分析显示，年龄是与牙尖弯曲相关的唯一因素。结论鼻尖弯曲是老年人AR最常见的病因。术前TEE检测鼻尖弯曲将扩大AR的治疗策略，包括主动脉瓣成形术。
PurposeThe prevalence of valvular heart disease has been rising, especially among those ≥ 65 years of age, because of age-related valvular degeneration resulting in an increase in the number of patients diagnosed with aortic regurgitation (AR). We analyzed transesophageal echocardiography (TEE) images in AR patients to identify the etiologies and investigate any differences in them according to age.MethodsWe studied 146 consecutive patients with chronic moderate or severe AR who underwent TEE. AR etiology was evaluated based on the TEE images in all the patients, as well as in each group separated by age.ResultsThe total number of patients eligible was 126 (mean age 67 ± 12 years), consisting of an older group (n= 85, mean age 74 ± 5 years) and younger group (n= 41, mean age 52 ± 11 years). In total, the most common etiology of AR was cusp bending (33.0%). In the older group, it was the most frequent as well (48.2%), with the right coronary cusp being the most commonly affected site (90.2%). In the younger group, bicuspid aortic valve was the most common (36.5%). Subsequently, all the study subjects were re-classified into two groups according to the presence/absence of cusp bending. Multivariate analysis revealed that age was the only factor associated with cusp bending.ConclusionCusp bending was the most frequent etiology of AR in the elderly. Preoperative detection of cusp bending by TEE would expand the therapeutic strategy for AR, including aortic valvuloplasty.