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Etiologies of Hemodynamically Significant Aortic Regurgitation and Coronary Cusp Bending: Evaluation by Transesophageal Echocardiography
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  • Naoki Hoshino,
  • Akira Yamada,
  • Meiko Hoshino,
  • Yuka Kawada,
  • Sayuri Yamabe,
  • Kayoko Takada,
  • Kunihiko Sugimoto,
  • Hideo Izawa
Naoki Hoshino
Fujita Health University
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Akira Yamada
Fujita Health University
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Meiko Hoshino
Fujita Health University
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Yuka Kawada
Fujita Health University
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Sayuri Yamabe
Fujita Health University
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Kayoko Takada
Fujita Health University
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Kunihiko Sugimoto
Fujita Health University Hospital
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Hideo Izawa
Fujita Health University
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Abstract

Background: While the number of patients with aortic regurgitation (AR) has been increasing in the aging society, its etiologies remain to be fully elucidated. Methods: We studied consecutive 126 patients with chronic moderate or severe AR who underwent TEE. After the study subjects were divided into 2 groups by the age of 65 years, AR etiology was examined in each group. Results: In the older group (n = 85), cusp bending was the most frequent cause of AR (48.2%), and right coronary cusp (RCC) was the most common (90.2%). In the younger group (n=41), bicuspid valve was the most frequent cause (36.5%), and cusp bending was less frequent (16.5%). Multivariate analysis revealed that age was the only factor associated with cusp bending. Conclusion: Cusp bending of RCC was the most frequent etiology of AR in the elderly. Because AR caused by cusp bending has a possibility to be mended by aortic plasty, it is important to detect it by TEE especially in the older patients.

Peer review status:IN REVISION

06 Apr 2021Submitted to Echocardiography
07 Apr 2021Submission Checks Completed
07 Apr 2021Assigned to Editor
15 Apr 2021Reviewer(s) Assigned
30 Apr 2021Review(s) Completed, Editorial Evaluation Pending
07 May 2021Editorial Decision: Revise Major
17 May 20211st Revision Received
20 May 2021Assigned to Editor
20 May 2021Submission Checks Completed