Aortic Regurgitation Jet Increases Left Ventricular Energy Loss Associated With the Progression of Cardiac Failure ― A Vector Flow Mapping Analysis Study ―
Abstract
BACKGROUND: Aortic valve regurgitation (AR) impairs cardiac function, but the underlying mechanisms remain unclear. Vector flow mapping (VFM) enables evaluation of blood flow patterns and energy loss in the left ventricle (LV). This study investigated the effect of AR on LV blood flow patterns, energy loss, and heart failure progression using VFM. METHODS AND RESULTS: Forty patients with severe AR undergoing aortic valve replacement (AVR) between January 2016 and March 2018 were included. Echocardiogram-based VFM in apical long-axis and 4-chamber views was performed before and after AVR, with results compared to a control group without valvular diseases (n=21). Preoperative LV energy loss due to an AR jet was significantly higher in patients with AR (median 8.7 J; interquartile range [IQR] 5.7-13.3 J) than in controls (1.7 J; IQR 0.7-2.6 J; P<0.001), and was positively correlated with preoperative serum B-type natriuretic peptide (BNP) concentrations (P=0.029). LV energy loss was not associated with LV systolic function or regurgitant volume, but was significantly affected by AR jet direction. Postoperatively, after AVR, LV energy loss (median 2.0 J; IQR 1.5-2.7 J) decreased to the same level as in the control group. CONCLUSIONS: The regurgitant jet in severe AR increases LV energy loss, which is positively correlated with serum BNP concentrations, indicating that the AR jet contributes to the progression of heart failure through LV energy loss.
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BibTeX
@article{yoshida2026aortic,
title = {{Aortic Regurgitation Jet Increases Left Ventricular Energy Loss Associated With the Progression of Cardiac Failure ― A Vector Flow Mapping Analysis Study ―}},
author = {Shohei Yoshida and Koichi Toda and Yasushi Yoshikawa and Hiroki Hata and Daisuke Yoshioka and Satoshi Kainuma and Takuji Kawamura and Ai Kawamura and Koichi Inoue and Yumi Kakizawa and Scott DeRoo and Christopher R. Burke and Satoshi Nakatani and Kazuo Shimamura and Yoshiki Sawa and Shigeru Miyagawa},
journal = {Circulation Journal},
year = {2026},
month = aug,
doi = {10.1253/circj.cj-24-0965},
url = {https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-24-0965/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Aortic Regurgitation Jet Increases Left Ventricular Energy Loss Associated With the Progression of Cardiac Failure ― A Vector Flow Mapping Analysis Study ―
AU - Shohei Yoshida
AU - Koichi Toda
AU - Yasushi Yoshikawa
AU - Hiroki Hata
AU - Daisuke Yoshioka
AU - Satoshi Kainuma
AU - Takuji Kawamura
AU - Ai Kawamura
AU - Koichi Inoue
AU - Yumi Kakizawa
AU - Scott DeRoo
AU - Christopher R. Burke
AU - Satoshi Nakatani
AU - Kazuo Shimamura
AU - Yoshiki Sawa
AU - Shigeru Miyagawa
PY - 2026
DA - 2026/08/25
JO - Circulation Journal
DO - 10.1253/circj.cj-24-0965
UR - https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-24-0965/_article
AB - BACKGROUND: Aortic valve regurgitation (AR) impairs cardiac function, but the underlying mechanisms remain unclear. Vector flow mapping (VFM) enables evaluation of blood flow patterns and energy loss in the left ventricle (LV). This study investigated the effect of AR on LV blood flow patterns, energy loss, and heart failure progression using VFM. METHODS AND RESULTS: Forty patients with severe AR undergoing aortic valve replacement (AVR) between January 2016 and March 2018 were included. Echocardiogram-based VFM in apical long-axis and 4-chamber views was performed before and after AVR, with results compared to a control group without valvular diseases (n=21). Preoperative LV energy loss due to an AR jet was significantly higher in patients with AR (median 8.7 J; interquartile range [IQR] 5.7-13.3 J) than in controls (1.7 J; IQR 0.7-2.6 J; P<0.001), and was positively correlated with preoperative serum B-type natriuretic peptide (BNP) concentrations (P=0.029). LV energy loss was not associated with LV systolic function or regurgitant volume, but was significantly affected by AR jet direction. Postoperatively, after AVR, LV energy loss (median 2.0 J; IQR 1.5-2.7 J) decreased to the same level as in the control group. CONCLUSIONS: The regurgitant jet in severe AR increases LV energy loss, which is positively correlated with serum BNP concentrations, indicating that the AR jet contributes to the progression of heart failure through LV energy loss.
SN - 1347-4820
SN - 1346-9843
ER -