Aortic regurgitation risk factors: Difference between revisions

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{| class="infobox" style="float:right;"
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| [[File:Siren.gif|30px|link=Aortic regurgitation resident survival guide]]|| <br> || <br>
| [[Aortic regurgitation resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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{{Aortic insufficiency}}
{{Aortic insufficiency}}
{{CMG}}; {{AOEIC}} {{VK}}, {{LG}}, [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]  
{{CMG}}; {{AOEIC}} {{VK}}; {{LG}}; [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org] ; {{USAMA}}
 
==Overview==
==Overview==
In the past, the most common risk factor for aortic valvular disease had been [[rheumatic fever]], with subsequent fibrosis of the scarred valve then leading to retraction of the [[aortic valve cusps]] and prevention of their apposition during [[diastole]]. In the modern era, a more common risk factor for acquired aortic regurgitation is [[degenerative]] disease of the aorta and aortic valve in which case there is calcification and fibrosis of the cusps. [[Infective endocarditis]] remains an important risk factor and cause of aortic insufficiency. [[Congenital]] conditions such as congenital bicuspid aortic valve or a [[ventricular septal defect]] can also result in aortic insufficiency. Patients with [[bicuspid aortic valve]] are at increased risk of developing [[aortic dissection]] <ref name="pmid12186790">{{cite journal |author=Fedak PW, Verma S, David TE, Leask RL, Weisel RD, Butany J |title=Clinical and pathophysiological implications of a bicuspid aortic valve |journal=[[Circulation]] |volume=106 |issue=8 |pages=900–4 |year=2002 |month=August |pmid=12186790 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=12186790 |accessdate=2011-03-28}}</ref>.
In the past, the most common risk factor for aortic valvular disease had been the rheumatic fever, with subsequent fibrosis of the scarred valve then leading to retraction of the aortic valve cusps and prevention of their apposition during diastole. In the modern era, a more common risk factor for acquired aortic regurgitation is degenerative disease of the aorta and aortic valve in which case there is calcification and fibrosis of the cusps. Infective endocarditis remains an important risk factor and cause of aortic regurgitation. Congenital conditions such as congenital bicuspid aortic valve or a ventricular septal defect can also result in aortic regurgitation. Patients with bicuspid aortic valve are at increased risk of developing aortic dissection.


==Risk factors==
==Risk Factors==
===Risk Factors for Aortic Root Disease===
===Risk Factors for Aortic Root Disease===
Risk factors for the development of aortic insufficiency due to aortic root disease include:
Risk factors for the development of aortic regurgitation due to aortic root disease include:<ref name="pmid15470217">{{cite journal| author=Enriquez-Sarano M, Tajik AJ| title=Clinical practice. Aortic regurgitation. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 15 | pages= 1539-46 | pmid=15470217 | doi=10.1056/NEJMcp030912 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15470217  }} </ref><ref name="pmid15172299">{{cite journal |author=Onorati F, De Santo LS, Carozza A, De Feo M, Renzulli A, Cotrufo M |title=Marfan syndrome as a predisposing factor for traumatic aortic insufficiency |journal=[[The Annals of Thoracic Surgery]] |volume=77 |issue=6 |pages=2192–4 |year=2004 |month=June |pmid=15172299 |doi=10.1016/S0003-4975(03)01409-7 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003497503014097 |accessdate=2011-03-28}}</ref><ref name="pmid8267458">{{cite journal |author=Prêtre R, Faidutti B |title=Surgical management of aortic valve injury after nonpenetrating trauma |journal=[[The Annals of Thoracic Surgery]] |volume=56 |issue=6 |pages=1426–31 |year=1993 |month=December |pmid=8267458 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0003-4975(93)90708-P |accessdate=2011-03-28}}</ref><ref name="pmid27267341">{{cite journal| author=Ferreira TF, Freire M, Teodoro RB| title=Difficulties in the differential diagnosis between Takayasu arteritis and rheumatic fever: case report. | journal=Rev Bras Reumatol Engl Ed | year= 2016 | volume= 56 | issue= 1 | pages= 90-2 | pmid=27267341 | doi=10.1016/j.rbre.2015.07.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27267341  }} </ref><ref name="Kim-1996">{{Cite journal  | last1 = Kim | first1 = M. | last2 = Roman | first2 = MJ. | last3 = Cavallini | first3 = MC. | last4 = Schwartz | first4 = JE. | last5 = Pickering | first5 = TG. | last6 = Devereux | first6 = RB. | title = Effect of hypertension on aortic root size and prevalence of aortic regurgitation. | journal = Hypertension | volume = 28 | issue = 1 | pages = 47-52 | month = Jul | year = 1996 | doi =  | PMID = 8675263 }}</ref><ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref>
 
<div style="-moz-column-count:2; column-count:2;">
<div style="-moz-column-count:2; column-count:2;">
*[[Ankylosing spondylitis]]
*[[Ankylosing spondylitis]]
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*[[Giant cell arteritis]]
*[[Giant cell arteritis]]
*[[Hypertension]]
*[[Hypertension]]
*Idiopathic dilation of the [[ascending aorta]]
*[[Idiopathic]] dilation of the [[ascending aorta]]
*[[Marfan syndrome]]
*[[Marfan syndrome]]
*[[Osteogenesis imperfecta]]
*[[Osteogenesis imperfecta]]
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*[[Reiter's syndrome]]
*[[Reiter's syndrome]]
*[[Relapsing polychondritis]]
*[[Relapsing polychondritis]]
*Senile aortic ectasia and dilation
*[[Senile]] aortic ectasia and dilation
*[[Spondyloarthropathy]]
*[[Spondyloarthropathy]]
*[[Syphilitic]] aortitis
*[[Syphilitic aortitis]]
*[[Takayasu arteritis]]
*[[Takayasu arteritis]]
*[[Trauma]]
*[[Trauma]]
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===Risk Factors for Aortic Valve Disease===
===Risk Factors for Aortic Valve Disease===
Risk factors for the development of aortic insufficiency due to aortic valve disease include:
Risk factors for the development of aortic regurgitation due to aortic valve disease include:<ref name="pmid15172299">{{cite journal |author=Onorati F, De Santo LS, Carozza A, De Feo M, Renzulli A, Cotrufo M |title=Marfan syndrome as a predisposing factor for traumatic aortic insufficiency |journal=[[The Annals of Thoracic Surgery]] |volume=77 |issue=6 |pages=2192–4 |year=2004 |month=June |pmid=15172299 |doi=10.1016/S0003-4975(03)01409-7 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003497503014097 |accessdate=2011-03-28}}</ref><ref name="pmid8267458">{{cite journal |author=Prêtre R, Faidutti B |title=Surgical management of aortic valve injury after nonpenetrating trauma |journal=[[The Annals of Thoracic Surgery]] |volume=56 |issue=6 |pages=1426–31 |year=1993 |month=December |pmid=8267458 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0003-4975(93)90708-P |accessdate=2011-03-28}}</ref><ref name="Bekeredjian-2005">{{Cite journal  | last1 = Bekeredjian | first1 = R. | last2 = Grayburn | first2 = PA. | title = Valvular heart disease: aortic regurgitation. | journal = Circulation | volume = 112 | issue = 1 | pages = 125-34 | month = Jul | year = 2005 | doi = 10.1161/CIRCULATIONAHA.104.488825 | PMID = 15998697 }}</ref><ref name="pmid24603191">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2014 | volume= 63 | issue= 22 | pages= e57-185 | pmid=24603191 | doi=10.1016/j.jacc.2014.02.536 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24603191  }} </ref><ref name="pmid27491900">{{cite journal| author=Ribeiro HB, Orwat S, Hayek SS, Larose É, Babaliaros V, Dahou A et al.| title=Cardiovascular Magnetic Resonance to Evaluate Aortic Regurgitation After Transcatheter Aortic Valve Replacement. | journal=J Am Coll Cardiol | year= 2016 | volume= 68 | issue= 6 | pages= 577-85 | pmid=27491900 | doi=10.1016/j.jacc.2016.05.059 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27491900  }} </ref> <ref name="pmid10">{{cite journal |vauthors=Schmoldt A, Benthe HF, Haberland G, Raffle A, Gray J, MacDonald HR, Ehrhart IC, Parker PE, Weidner WJ, Dabney JM, Scott JB, Haddy FJ, Gatzy JT |title=Digitoxin metabolism by rat liver microsomes |journal=Biochem. Pharmacol. |volume=24 |issue=17 |pages=1639–41 |date=September 1975 |pmid=10 |pmc=5922622 |doi=10.1136/bmj.1.6001.93-a |url=}}</ref>
<div style="-moz-column-count:2; column-count:2;">
<div style="-moz-column-count:2; column-count:2;">
*[[Bicuspid aortic valve]]
*[[Bicuspid aortic valve]]
*[[Collagen vascular disease]]
*[[Collagen vascular disease]]
*Senile or degenerative calcific aortic valve disease
*[[Senile]] or degenerative [[calcific aortic valve disease]]
*[[Endocarditis]]
*[[Endocarditis]]
* [[Myxomatous]] aortic valve
*[[Myxomatous]] [[aortic valve]]
*[[Rheumatic fever]]
*[[Rheumatic fever]]
*[[Rheumatoid arthritis]]
*[[Rheumatoid arthritis]]
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*[[Systemic Lupus Erythematosus]]
*[[Systemic Lupus Erythematosus]]
*[[Trauma]]
*[[Trauma]]
*[[Marfan Syndrome]]
*[[Turner's Syndrome]]
*[[Turner's Syndrome]]
*[[Ventricular Septal Defect]]
*[[Ventricular Septal Defect]]
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</div>
</div>


===Risk factors for Acute Aortic Insufficiency===
===Risk Factors for Acute Aortic Regurgitation===
The risk factors for Acute Aortic Regurgitation include the following:<ref name="pmid15172299">{{cite journal |author=Onorati F, De Santo LS, Carozza A, De Feo M, Renzulli A, Cotrufo M |title=Marfan syndrome as a predisposing factor for traumatic aortic insufficiency |journal=[[The Annals of Thoracic Surgery]] |volume=77 |issue=6 |pages=2192–4 |year=2004 |month=June |pmid=15172299 |doi=10.1016/S0003-4975(03)01409-7 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003497503014097 |accessdate=2011-03-28}}</ref><ref name="pmid8267458">{{cite journal |author=Prêtre R, Faidutti B |title=Surgical management of aortic valve injury after nonpenetrating trauma |journal=[[The Annals of Thoracic Surgery]] |volume=56 |issue=6 |pages=1426–31 |year=1993 |month=December |pmid=8267458 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0003-4975(93)90708-P |accessdate=2011-03-28}}</ref><ref name="pmid2016464">{{cite journal |author=Isner JM |title=Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators |journal=[[Journal of the American College of Cardiology]] |volume=17 |issue=6 |pages=1436–44 |year=1991 |month=May |pmid=2016464 |doi= |url= |accessdate=2011-03-28}}</ref><ref name="Stiles-1980">{{Cite journal  | last1 = Stiles | first1 = GL. | last2 = Friesinger | first2 = GC. | title = Bacterial endocarditis with aortic regurgitation: implications of embolism. | journal = South Med J | volume = 73 | issue = 5 | pages = 582-6 | month = May | year = 1980 | doi =  | PMID = 7375973 }}</ref><ref name="Spagnuolo-1971">{{Cite journal  | last1 = Spagnuolo | first1 = M. | last2 = Kloth | first2 = H. | last3 = Taranta | first3 = A. | last4 = Doyle | first4 = E. | last5 = Pasternack | first5 = B. | title = Natural history of rheumatic aortic regurgitation. Criteria predictive of death, congestive heart failure, and angina in young patients. | journal = Circulation | volume = 44 | issue = 3 | pages = 368-80 | month = Sep | year = 1971 | doi = | PMID = 4255488 }}</ref>
<div style="-moz-column-count:2; column-count:2;">
<div style="-moz-column-count:2; column-count:2;">
* After [[aortic valvuloplasty]]<ref name="pmid2016464">{{cite journal |author=Isner JM |title=Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators |journal=[[Journal of the American College of Cardiology]] |volume=17 |issue=6 |pages=1436–44 |year=1991 |month=May |pmid=2016464 |doi= |url= |accessdate=2011-03-28}}</ref>
*After [[aortic valvuloplasty]]
* [[Aortic dissection]]
*[[Aortic dissection]]
* [[Bacterial Endocarditis]]
*[[Bacterial Endocarditis]]
* Blunt [[chest trauma]]
*Blunt [[chest trauma]]
* [[Myxomatous]] aortic valve
*[[Myxomatous]] [[aortic valve]]
* [[Rheumatic Fever]]
*[[Rheumatic Fever]]
</div>
</div>


===Risk Factors for Chronic Aortic Insufficiency===
===Risk Factors for Chronic Aortic Regurgitation===
The risk factors for Chronic Aortic Regurgitation include:<ref name="Kim-1996">{{Cite journal  | last1 = Kim | first1 = M. | last2 = Roman | first2 = MJ. | last3 = Cavallini | first3 = MC. | last4 = Schwartz | first4 = JE. | last5 = Pickering | first5 = TG. | last6 = Devereux | first6 = RB. | title = Effect of hypertension on aortic root size and prevalence of aortic regurgitation. | journal = Hypertension | volume = 28 | issue = 1 | pages = 47-52 | month = Jul | year = 1996 | doi =  | PMID = 8675263 }}</ref><ref name="Stiles-1980">{{Cite journal  | last1 = Stiles | first1 = GL. | last2 = Friesinger | first2 = GC. | title = Bacterial endocarditis with aortic regurgitation: implications of embolism. | journal = South Med J | volume = 73 | issue = 5 | pages = 582-6 | month = May | year = 1980 | doi =  | PMID = 7375973 }}</ref><ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref><ref name="Pereira-2004">{{Cite journal  | last1 = Pereira | first1 = AM. | last2 = van Thiel | first2 = SW. | last3 = Lindner | first3 = JR. | last4 = Roelfsema | first4 = F. | last5 = van der Wall | first5 = EE. | last6 = Morreau | first6 = H. | last7 = Smit | first7 = JW. | last8 = Romijn | first8 = JA. | last9 = Bax | first9 = JJ. | title = Increased prevalence of regurgitant valvular heart disease in acromegaly. | journal = J Clin Endocrinol Metab | volume = 89 | issue = 1 | pages = 71-5 | month = Jan | year = 2004 | doi =  | PMID = 14715829 }}</ref><ref name="Wunderlich-2005">{{Cite journal  | last1 = Wunderlich | first1 = C. | last2 = Schulze | first2 = MR. | last3 = Strasser | first3 = RH. | title = Severe aortic regurgitation in Ehlers-Danlos syndrome type IV. | journal = Heart | volume = 91 | issue = 1 | pages = 126 | month = Jan | year = 2005 | doi = 10.1136/hrt.2004.035097 | PMID = 15604357 }}</ref> <ref name="pmid17519398">{{cite journal| author=Pierpont ME, Basson CT, Benson DW, Gelb BD, Giglia TM, Goldmuntz E et al.| title=Genetic basis for congenital heart defects: current knowledge: a scientific statement from the American Heart Association Congenital Cardiac Defects Committee, Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. | journal=Circulation | year= 2007 | volume= 115 | issue= 23 | pages= 3015-38 | pmid=17519398 | doi=10.1161/CIRCULATIONAHA.106.183056 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17519398  }} </ref>
<div style="-moz-column-count:2; column-count:2;">
<div style="-moz-column-count:2; column-count:2;">
* [[Ankylosing Spondylitis]]
* [[Ankylosing Spondylitis]]
* [[Aortic Dissection]]
* [[Aortic Dissection]]
* [[Acromegaly]]
* [[Arteriosclerosis]]
* [[Arteriosclerosis]]
* [[Bacterial Endocarditis]]
* [[Bacterial Endocarditis]]
* [[Bechterew's Disease]]
* [[Bechterew's Disease]]
* [[Bicuspid aortic valve]]
* [[Bicuspid aortic valve]]
* [[Cystic medial necrosis]] of the aorta
* [[Cystic medial necrosis]] of the [[aorta]]
* [[Ehlers-Danlos Syndrome]]
* [[Ehlers-Danlos Syndrome]]
* [[Hypertension]]
* [[Hypertension]]
* [[Marfan Syndrome]]
* [[Marfan Syndrome]]
* [[Myxomatous]] aortic valve
* [[Myxomatous]] [[aortic valve]]
* [[Polymyalgia Rheumatica]]
* [[Polymyalgia Rheumatica]]
* [[Pseudoxanthoma Elasticum]]
* [[Pseudoxanthoma Elasticum]]
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* [[Weight loss]] medications
* [[Weight loss]] medications
</div>
</div>
==Precautions==
People with aortic insufficiency of any aetiology are at risk for the development of infection of their damaged valve, i.e. [[infective endocarditis]]. To lessen the chance of developing that serious complication, people with AI are usually advised to take antibiotic prophylaxis around the time of certain dental/medical/surgical procedures. Routine upper and lower GI [[endoscopy]] (i.e. [[gastroscopy]] and [[colonoscopy]]), with or without [[biopsy]], are not usually considered indications for antibiotic prophylaxis.
Not withstanding the foregoing, the [[American Heart Association]] has recently changed its recommendations regarding antibiotic prophylaxis for endocarditis. Specifically, as of 2007, it is recommended that such prophylaxis be limited only to:
*Those with prosthetic heart valves.
*Those with previous episode(s) of [[endocarditis]].
*Those with certain types of [[congenital heart disease]] <ref>http://www.americanheart.org/presenter.jhtml?identifier=4436</ref>.


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Cardiology]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[es:Estenosis aórtica]]
[[es:Estenosis aórtica]]
[[fr:Rétrécissement aortique]]
[[fr:Rétrécissement aortique]]
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[[ro:Stenoza Aortică]]
[[ro:Stenoza Aortică]]
[[tr:Aort darlığı]]
[[tr:Aort darlığı]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[CME Category::Cardiology]]
[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Valvular heart disease]]
[[Category:Congenital heart disease]]
[[Category:Surgery]]
[[Category:Cardiac surgery]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]; Lakshmi Gopalakrishnan, M.B.B.S. [3]; Mohammed A. Sbeih, M.D. [4] ; Usama Talib, BSc, MD [5]

Overview

In the past, the most common risk factor for aortic valvular disease had been the rheumatic fever, with subsequent fibrosis of the scarred valve then leading to retraction of the aortic valve cusps and prevention of their apposition during diastole. In the modern era, a more common risk factor for acquired aortic regurgitation is degenerative disease of the aorta and aortic valve in which case there is calcification and fibrosis of the cusps. Infective endocarditis remains an important risk factor and cause of aortic regurgitation. Congenital conditions such as congenital bicuspid aortic valve or a ventricular septal defect can also result in aortic regurgitation. Patients with bicuspid aortic valve are at increased risk of developing aortic dissection.

Risk Factors

Risk Factors for Aortic Root Disease

Risk factors for the development of aortic regurgitation due to aortic root disease include:[1][2][3][4][5][6]

Risk Factors for Aortic Valve Disease

Risk factors for the development of aortic regurgitation due to aortic valve disease include:[2][3][7][8][9] [10]

Risk Factors for Acute Aortic Regurgitation

The risk factors for Acute Aortic Regurgitation include the following:[2][3][11][12][13]

Risk Factors for Chronic Aortic Regurgitation

The risk factors for Chronic Aortic Regurgitation include:[5][12][14][15][16] [17]

References

  1. ↑ Enriquez-Sarano M, Tajik AJ (2004). "Clinical practice. Aortic regurgitation". N Engl J Med. 351 (15): 1539–46. doi:10.1056/NEJMcp030912. PMID 15470217.
  2. ↑ 2.0 2.1 2.2 Onorati F, De Santo LS, Carozza A, De Feo M, Renzulli A, Cotrufo M (2004). "Marfan syndrome as a predisposing factor for traumatic aortic insufficiency". The Annals of Thoracic Surgery. 77 (6): 2192–4. doi:10.1016/S0003-4975(03)01409-7. PMID 15172299. Retrieved 2011-03-28. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 3.2 Prêtre R, Faidutti B (1993). "Surgical management of aortic valve injury after nonpenetrating trauma". The Annals of Thoracic Surgery. 56 (6): 1426–31. PMID 8267458. Retrieved 2011-03-28. Unknown parameter |month= ignored (help)
  4. ↑ Ferreira TF, Freire M, Teodoro RB (2016). "Difficulties in the differential diagnosis between Takayasu arteritis and rheumatic fever: case report". Rev Bras Reumatol Engl Ed. 56 (1): 90–2. doi:10.1016/j.rbre.2015.07.001. PMID 27267341.
  5. ↑ 5.0 5.1 Kim, M.; Roman, MJ.; Cavallini, MC.; Schwartz, JE.; Pickering, TG.; Devereux, RB. (1996). "Effect of hypertension on aortic root size and prevalence of aortic regurgitation". Hypertension. 28 (1): 47–52. PMID 8675263. Unknown parameter |month= ignored (help)
  6. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  7. ↑ Bekeredjian, R.; Grayburn, PA. (2005). "Valvular heart disease: aortic regurgitation". Circulation. 112 (1): 125–34. doi:10.1161/CIRCULATIONAHA.104.488825. PMID 15998697. Unknown parameter |month= ignored (help)
  8. ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 63 (22): e57–185. doi:10.1016/j.jacc.2014.02.536. PMID 24603191.
  9. ↑ Ribeiro HB, Orwat S, Hayek SS, Larose É, Babaliaros V, Dahou A; et al. (2016). "Cardiovascular Magnetic Resonance to Evaluate Aortic Regurgitation After Transcatheter Aortic Valve Replacement". J Am Coll Cardiol. 68 (6): 577–85. doi:10.1016/j.jacc.2016.05.059. PMID 27491900.
  10. ↑ Schmoldt A, Benthe HF, Haberland G, Raffle A, Gray J, MacDonald HR, Ehrhart IC, Parker PE, Weidner WJ, Dabney JM, Scott JB, Haddy FJ, Gatzy JT (September 1975). "Digitoxin metabolism by rat liver microsomes". Biochem. Pharmacol. 24 (17): 1639–41. doi:10.1136/bmj.1.6001.93-a. PMC 5922622. PMID 10.
  11. ↑ Isner JM (1991). "Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators". Journal of the American College of Cardiology. 17 (6): 1436–44. PMID 2016464. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  12. ↑ 12.0 12.1 Stiles, GL.; Friesinger, GC. (1980). "Bacterial endocarditis with aortic regurgitation: implications of embolism". South Med J. 73 (5): 582–6. PMID 7375973. Unknown parameter |month= ignored (help)
  13. ↑ Spagnuolo, M.; Kloth, H.; Taranta, A.; Doyle, E.; Pasternack, B. (1971). "Natural history of rheumatic aortic regurgitation. Criteria predictive of death, congestive heart failure, and angina in young patients". Circulation. 44 (3): 368–80. PMID 4255488. Unknown parameter |month= ignored (help)
  14. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  15. ↑ Pereira, AM.; van Thiel, SW.; Lindner, JR.; Roelfsema, F.; van der Wall, EE.; Morreau, H.; Smit, JW.; Romijn, JA.; Bax, JJ. (2004). "Increased prevalence of regurgitant valvular heart disease in acromegaly". J Clin Endocrinol Metab. 89 (1): 71–5. PMID 14715829. Unknown parameter |month= ignored (help)
  16. ↑ Wunderlich, C.; Schulze, MR.; Strasser, RH. (2005). "Severe aortic regurgitation in Ehlers-Danlos syndrome type IV". Heart. 91 (1): 126. doi:10.1136/hrt.2004.035097. PMID 15604357. Unknown parameter |month= ignored (help)
  17. ↑ Pierpont ME, Basson CT, Benson DW, Gelb BD, Giglia TM, Goldmuntz E; et al. (2007). "Genetic basis for congenital heart defects: current knowledge: a scientific statement from the American Heart Association Congenital Cardiac Defects Committee, Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics". Circulation. 115 (23): 3015–38. doi:10.1161/CIRCULATIONAHA.106.183056. PMID 17519398.

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