Quantification of aortic regurgitation severity by left ventricular to right ventricular stroke volume ratio

ABSTRACT

Echocardiography is the most common test used for the evaluation of aortic regurgitation [AR]. However, the role of echocardiography as an available and inexpensive method in the quantification of AR by the left ventricle to right ventricle stroke volume ratio [LV/RV SV ratio] has not been completely investigated. Between June 2005 and December 2007, 132 consecutive patients with AR [mean age 44.7 +/- 14.6 years, 52.3% male] were enrolled in the study. All the patients underwent echocardiography; and aortography, if indicated, was performed as well. Fifty-two percent of the patients had severe AR. There was almost a perfect agreement between echocardiography and cardiac catheterization in determining the severity of AR [Kappa=0.81]. Associated valvular disease was found in 81.8% of the patients, the most common disease being mitral regurgitation [61%]. The results of our bivariate and multivariate analyses showed a significant relation between the LV/RV SV ratio and the AR severity via either echocardiography or cardiac catheterization [both P=0.001]. The receiver operating characteristic [ROC] curve analysis showed that the LV/RV SV ratio was very accurate in the detection of severe AR utilizing cardiac catheterization as the gold standard [AUC=0.71]. The cut point value of the LV/RV SV ratio sensitivity of 56% and specificity of 75% for the differentiation of non-severe from severe AR. Our study demonstrated that the LV/RV SV ratio was a simple and reliable method for the assessment of the severity of AR. This method is more accurate in the absence of a significant involvement of the other valves