Aortic regurgitation risk factors

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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]

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.^[1]

Risk Factors

Risk Factors for Aortic Root Disease

Risk factors for the development of aortic regurgitation due to aortic root disease include:^[2]^[3]^[4]^[5]^[6]^[7]

Ankylosing spondylitis
Aortic dissection
Arteriosclerosis
Bechterew's Disease
Behcet's syndrome
Cystic medial necrosis of the aorta
Ehlers-Danlos Syndrome
Giant cell arteritis
Hypertension
Idiopathic dilation of the ascending aorta
Marfan syndrome
Osteogenesis imperfecta
Polymyalgia Rheumatica
Pseudoxanthoma Elasticum
Psoriatic arthritis
Reiter's syndrome
Relapsing polychondritis
Senile aortic ectasia and dilation
Spondyloarthropathy
Syphilitic aortitis
Takayasu arteritis
Trauma
Ulcerative colitis
Whipple's disease

Risk Factors for Aortic Valve Disease

Risk factors for the development of aortic regurgitation due to aortic valve disease include:^[3]^[4]^[8]^[9]^[10]

Bicuspid aortic valve
Collagen vascular disease
Senile or degenerative calcific aortic valve disease
Endocarditis
Myxomatous aortic valve
Rheumatic fever
Rheumatoid arthritis
Sinus of Valsalva Aneurysm
Systemic Lupus Erythematosus
Trauma
Marfan Syndrome
Turner's Syndrome
Ventricular Septal Defect
Weight loss medications

Risk Factors for Acute Aortic Regurgitation

The risk factors for Acute Aortic Regurgitation include the following:^[3]^[4]^[11]^[12]^[13]

Risk Factors for Chronic Aortic Regurgitation

The risk factors for Chronic Aortic Regurgitation include:^[6]^[14]^[15]^[12]^[16]

References

↑ Fedak PW, Verma S, David TE, Leask RL, Weisel RD, Butany J (2002). "Clinical and pathophysiological implications of a bicuspid aortic valve". Circulation. 106 (8): 900–4. PMID 12186790. Retrieved 2011-03-28. Unknown parameter |month= ignored (help)
↑ Enriquez-Sarano M, Tajik AJ (2004). "Clinical practice. Aortic regurgitation". N Engl J Med. 351 (15): 1539–46. doi:10.1056/NEJMcp030912. PMID 15470217.
↑ ^3.0 ^3.1 ^3.2 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)
↑ ^4.0 ^4.1 ^4.2 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)
↑ 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.
↑ ^6.0 ^6.1 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)
↑ 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.
↑ 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)
↑ 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.
↑ 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.
↑ 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)
↑ ^12.0 ^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)
↑ 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)
↑ 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.
↑ 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)
↑ 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)

Template:WH Template:WS CME Category::Cardiology

[pmid12186790-1] Fedak PW, Verma S, David TE, Leask RL, Weisel RD, Butany J (2002). "Clinical and pathophysiological implications of a bicuspid aortic valve". Circulation. 106 (8): 900–4. PMID 12186790. Retrieved 2011-03-28. Unknown parameter |month= ignored (help)

[pmid15470217-2] Enriquez-Sarano M, Tajik AJ (2004). "Clinical practice. Aortic regurgitation". N Engl J Med. 351 (15): 1539–46. doi:10.1056/NEJMcp030912. PMID 15470217.

[pmid15172299-3] 3.0 ^3.1 ^3.2 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)

[pmid8267458-4] 4.0 ^4.1 ^4.2 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)

[pmid27267341-5] 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.

[Kim-1996-6] 6.0 ^6.1 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)

[7] 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.

[Bekeredjian-2005-8] 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)

[pmid24603191-9] 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.

[pmid27491900-10] 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.

[pmid2016464-11] 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)

[Stiles-1980-12] 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)

[Spagnuolo-1971-13] 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.

[Pereira-2004-15] 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)

[Wunderlich-2005-16] 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)

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