What is the clinical course and prognosis of aortic regurgitation (AR)?

Updated: Nov 19, 2018
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

In asymptomatic patients with decreased EF, the rate of progression to symptoms is greater than 25% per year, while in symptomatic patients, the mortality rate is over 10% per year.

The strongest predictors of outcome are echocardiographic parameters (EF and LV end-systolic dimension), underscoring the crucial role of serial echocardiography in the management of patients with severe AR.

Exercise LV end-systolic volume index (LVESVi) may have prognostic value as an independent predictor of outcomes in in patients with asymptomatic moderate or severe AR. [24]

Severe acute AR, if left untreated, is likely to lead to considerable morbidity and mortality from either the underlying cause (typically infective endocarditis or aortic dissection) or from hemodynamic decompensation of the LV.

Potential complications in patients with severe chronic AR include progressive LV dysfunction and dilation, congestive heart failure, myocardial ischemia, arrhythmia, and sudden death. Additional complications may arise as a result of the patient's underlying condition (such as aortic root dissection in a patient with a bicuspid aortic valve and a severely dilated aortic root).


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