Why the study?
What is the mechanism of diastolic aortic valve opening in severe aortic regurgitation?
What is the mechanism of diastolic aortic valve opening in severe aortic regurgitation?
Diastolic opening of the aortic valve in severe aortic regurgitation appears to be an active process driven by ventricular recoil mechanisms rather than passive flotation or atrial systole.
Hypothesis-generating for active recoil in diastolic aortic valve opening; requires prospective validation before mechanistic adoption.
Severe aortic regurgitation may be associated with premature aortic valve opening. Several possible etiologies for this diastolic opening have been suggested. We present a patient with hemodynamic data, M-mode and 2-D echocardiography in the setting of severe aortic regurgitation and diastolic aortic valve opening. Our data lead us to conclude that aortic valve opening in this situation is neither from passive flotation nor dependent on atrial systole. We believe that active ventricular recoil mechanisms can facilitate increases in diastolic ventricular pressure which then can transiently exceed aortic pressure in the setting of severe aortic regurgitation. This hemodynamic observation suggests that the valve opening is an active process.
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Martinez et al. (1986) studied this question.
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