Patients with dilated cardiomyopathy have been noted to have aortic regurgitation by Doppler echocardiography. To determine what the incidence of aortic regurgitation is in this population and its possible mechanism,we performed a retrospective study of patients referred to the echocardiography laboratory. From the échocardiographie database, 1,131 echocardiograms were identified with global left ventricular dysfunction. Of these 246 had structurally normal aortic valves, and 20% of them had Doppler-detected aortic regurgitation. These were compared to a control group of 20 subjects with normal left ventricular function and aortic regurgitation. Patients with dilated cardiomyopathy had a larger left ventricular dimension (p < 0.01) and a smaller shortening fraction (p < 0.01). There was no difference in the aortic root dimension between the two groups. Patients with dilated cardiomyopathy were more likely to have a centrally directed jet by color flow Doppler (22 of 24) than the control group (9 of 20; p <0.05). The jet appeared to originate at the coaptation point of the three aortic cusps in the dilated cardiomyopathy group. This suggests that there may be dilation of the aortic ring with subsequent abnormal closure of the aortic valve.

Keywords:
Aortic regurgitation, Color flow Doppler, Dilated cardiomyopathy
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1991
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