Pathophysiology of the aortic regurgitation Doppler signal end-diastolic notching: "A-dip insight".
Georgios GiannakopoulosFlorian ReyHajo MüllerPublished in: Echocardiography (Mount Kisco, N.Y.) (2020)
A 76-year-old man was admitted to the hospital with symptoms of severe decompensated heart failure. Initial echocardiogram showed normal left ventricular (LV) ejection fraction, grade II diastolic dysfunction, and mild-to-moderate aortic regurgitation. The aortic regurgitant Doppler signal exhibited an end-diastolic notching, called an A-dip. After intravenous diuretic therapy and 3 kg weight loss, a new echocardiogram was performed showing a grade I diastolic dysfunction and complete abolishment of the A-dip. Aortic A-dip is a rare finding denoting increased LV filling pressures. Conditions that favor its occurrence are increased LV stiffness, low diastolic blood pressure, and preserved left atrial contractility.
Keyphrases
- left ventricular
- aortic stenosis
- left atrial
- heart failure
- ejection fraction
- cardiac resynchronization therapy
- aortic valve
- hypertrophic cardiomyopathy
- blood pressure
- mitral valve
- acute myocardial infarction
- weight loss
- risk assessment
- oxidative stress
- healthcare
- heart rate
- transcatheter aortic valve replacement
- bariatric surgery
- adipose tissue
- coronary artery disease
- hypertensive patients
- coronary artery
- high dose
- pulmonary artery
- low dose
- roux en y gastric bypass
- pulmonary arterial hypertension
- sleep quality
- blood glucose
- acute coronary syndrome
- smoking cessation
- electronic health record