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Aortic Root Dilatation as a Cause of Isolated, Severe Aortic Regurgitation: Prevalence, Clinical and Echocardiographic Patterns, and Relation to Left Ventricular Hypertrophy and Function

MARY J. ROMAN, M.D.; RICHARD B. DEVEREUX, M.D.; NATHANIEL W. NILES, M.D.; CLARE HOCHREITER, M.D.; PAUL KLIGFIELD, M.D.; NINA SATO, B.S.; MARIANE C. SPITZER; and JEFFREY S. BORER, M.D.
[+] Article and Author Information

Grant support: in part by grant R01 HL 25604 from the National Heart, Lung, and Blood Institute.

▸ Requests for reprints should be addressed to Richard B. Devereux, M.D.; Division of Cardiology, Box 222, The New York Hospital-Cornell Medical Center, 525 East 63rd Street; New York, NY 10021.


New York, New York


© 1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;106(6):800-807. doi:10.7326/0003-4819-106-6-800
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To evaluate the relation of aortic root dilatation to aortic regurgitation, we examined clinical, echocardiographic, and radionuclide cineangiographic findings in 102 patients with severe aortic regurgitation. Aortic root dilatation was the only apparent cause in 31 patients (30%), exceeding in prevalence any valvular cause, and was independently associated only with older age (p < 0.001). Echocardiography showed dilatation to be either localized to the sinuses of Valsalva or to be generalized. At initial evaluation, patients with generalized dilatation had severer abnormalities of left ventricular size and function than those with localized or no dilatation. Aortic valves were subsequently replaced in more patients with generalized than localized dilatation during 28 ±17 month follow-up (9 of 15 patients compared with 2 of 15, p < 0.03). Thus, idiopathic aortic root dilatation is the commonest definable cause of severe aortic regurgitation; aortic root dilatation is associated independently with age but not blood pressure; and generalized aortic root dilatation is associated with marked ventricular dilatation, hypertrophy, and dysfunction.

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