Duplex sonography of the carotid arteries in patients with pure aortic regurgitation: pulse waveform and hemodynamic changes and a new indicator of the severity of aortic regurgitation.
OBJECTIVE
To determine the changes of multiple hemodynamic parameters and pulse wave contour in pure aortic regurgitation (AR) and to present a new indicator of the severity of AR (shrink ratio of proximal common carotid artery).


METHODS
The sonograms of 42 patients (31 M, 11 F; 16-68 years) with pure AR and 18 control subjects (15 M, 3 F; 20-47 years) were assessed for velocities and indices, and change of pulse wave contour (bisferious pattern, zero level and retrograde diastolic flow) in each carotid artery. Shrink ratio (maximum diameter-minimum diameter/maximum diameter) of each proximal common carotid artery was calculated.


RESULTS
Bisferious waveforms seen in patients with AR grade 1, grade 2, and grade 3-4 were 66%, 83%, and 88%, respectively. Diastolic reversed flow was determined in 7 (39%) of 18 patients with AR grade 3-4. Three patients (25%) with AR grade 2 and 4 patients (22%) with AR grade 3-4 had zero level diastolic flow in the common carotid artery. Statistically significant changes of decreased end-diastolic velocity, increased peak systolic velocity/end-diastolic velocity, resistivity index, and pulsatility index were revealed, especially in AR grade 3-4 compared to controls. Significantly increased shrink ratio was seen only in AR grade 3-4.


CONCLUSIONS
Increased shrink ratio or changes in hemodynamics or pulse waveform can be used in recognition of AR.
Kervancioglu
S
S
Department of Radiology, Faculty of Medicine, Gaziantep University, Universite Bulvari, Gaziantep, Turkey. skervancioglu@yahoo.com
Davutoglu
V
V
Ozkur
A
A
Soydinc
S
S
Adaletli
I
I
Sirikci
A
A
Bayram
M M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001022:Aortic Valve Insufficiency / Q000145:classification / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity / Q000502:physiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002342:Carotid Artery, External / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D013599:Systole / Q000502:physiology; D018616:Ultrasonography, Doppler, Duplex; D014655:Vascular Resistance / Q000502:physiology