Quantification of Aortic Regurgitation Severity by Left Ventricular to Right Ventricular Stroke Volume Ratio

Echocardiography is the most common test used for the evaluation of aortic regurgitation (AR). However, the role of echocardiography as an available and inexpensive method in the quantification of AR by the left ventricle to right ventricle stroke volume ratio (LV/RV SV ratio) has not been completely investigated. Between June 2005 and December 2007, 132 consecutive patients with AR (mean age: 44.7±14.6 years, 52.3% male) were enrolled in the study. All the patients underwent echocardiography; and aortography, if indicated, was performed as well. Fifty-two percent of the patients had severe AR. There was almost a perfect agreement between echocardiography and cardiac catheterization in determining the severity of AR (Kappa=0.81). Associated valvular disease was found in 81.8% of the patients, the most common disease being mitral regurgitation (61%). The results of our bivariate and multivariate analyses showed a significant relation between the LV/RV SV ratio and the AR severity via either echocardiography or cardiac catheterization (both P=0.001). The receiver operating characteristic (ROC) curve analysis showed that the LV/RV SV ratio was very accurate in the detection of severe AR utilizing cardiac catheterization as the gold standard (AUC=0.71). The cut point value of the LV/RV SV ratio ≤1.5 had a sensitivity of 56% and specificity of 75% for the differentiation of non-severe from severe AR. Our study demonstrated that the LV/RV SV ratio was a simple and reliable method for the assessment of the severity of AR. This method is more accurate in the absence of a significant involvement of the other valves.