Feasibility and diagnostic utility of echocardiographic distal abdominal aortic diastolic flow reversal for assessing aortic regurgitation.
4 affiliations
- 1Department of Cardiology, Aichi Medical University, 1-1, Yazakokarimata, Nagakute 480-1195, Japan.
- 2Department of Clinical Laboratory, Aichi Medical University, Nagakute, Japan.
- 3Yokkaichi Heart Clinic, Yokkaichi, Japan.
- 4NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan.
Abstract
Although abdominal aortic holo-diastolic flow reversal (HDFR) is a useful marker for aortic regurgitation (AR) severity, guidelines do not specify the optimal measurement site. We compared the feasibility of proximal vs. distal abdominal aortic diastolic flow reversal (DFR) measurements, evaluated the diagnostic accuracy of distal HDFR for severe AR, and assessed its consistency with cardiac magnetic resonance (CMR). We evaluated 103 patients with moderate (n = 81) or severe (n = 22) chronic AR. DFR feasibility was significantly higher in the distal than in the proximal segment (94% vs. 54%, P < 0.01). In the overall clinical diagnostic yield analysis (n = 103), distal DFR demonstrated a significantly higher diagnostic yield for AR severity grading compared with proximal DFR (82% vs. 50%, P < 0.01). In an exploratory paired analysis of patients with feasible DFR at both sites (n = 56), distal and proximal HDFR demonstrated no statistically significant differences in diagnostic performance for severe AR: sensitivity (92% vs. 85%, P = 1.00), specificity (86% vs. 93%, P = 0.38), and accuracy (88% vs. 91%, P = 0.73). Inter- and intra-observer reproducibility was excellent. Furthermore, echo-derived distal HDFR showed descriptive consistency with CMR-derived HDFR in a small exploratory subgroup (n = 12; 92% agreement, κ = 0.82). Distal abdominal aortic DFR is a simple and highly feasible method for assessing AR severity, potentially overcoming the limitations of proximal DFR assessment in routine clinical practice.
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BibTeX
@article{suzuki2026feasibility,
title = {{Feasibility and diagnostic utility of echocardiographic distal abdominal aortic diastolic flow reversal for assessing aortic regurgitation.}},
author = {Wataru Suzuki and Sakiko Kojima and Reina Takeda and Hirotsugu Mihara and Atomu Tajima and Masahiro Shimoda and Hirofumi Ohashi and Ayako Kunimura and Kentaro Mukai and Yusuke Nakano and Hirohiko Ando and Tetsuya Amano},
journal = {European heart journal. Imaging methods and practice},
year = {2026},
month = oct,
doi = {10.1093/ehjimp/qyag176},
url = {https://europepmc.org/article/MED/42953652},
note = {CC BY},
}
RIS
TY - JOUR
TI - Feasibility and diagnostic utility of echocardiographic distal abdominal aortic diastolic flow reversal for assessing aortic regurgitation.
AU - Wataru Suzuki
AU - Sakiko Kojima
AU - Reina Takeda
AU - Hirotsugu Mihara
AU - Atomu Tajima
AU - Masahiro Shimoda
AU - Hirofumi Ohashi
AU - Ayako Kunimura
AU - Kentaro Mukai
AU - Yusuke Nakano
AU - Hirohiko Ando
AU - Tetsuya Amano
PY - 2026
DA - 2026/10/12
JO - European heart journal. Imaging methods and practice
DO - 10.1093/ehjimp/qyag176
UR - https://europepmc.org/article/MED/42953652
AB - Although abdominal aortic holo-diastolic flow reversal (HDFR) is a useful marker for aortic regurgitation (AR) severity, guidelines do not specify the optimal measurement site. We compared the feasibility of proximal vs. distal abdominal aortic diastolic flow reversal (DFR) measurements, evaluated the diagnostic accuracy of distal HDFR for severe AR, and assessed its consistency with cardiac magnetic resonance (CMR). We evaluated 103 patients with moderate (n = 81) or severe (n = 22) chronic AR. DFR feasibility was significantly higher in the distal than in the proximal segment (94% vs. 54%, P < 0.01). In the overall clinical diagnostic yield analysis (n = 103), distal DFR demonstrated a significantly higher diagnostic yield for AR severity grading compared with proximal DFR (82% vs. 50%, P < 0.01). In an exploratory paired analysis of patients with feasible DFR at both sites (n = 56), distal and proximal HDFR demonstrated no statistically significant differences in diagnostic performance for severe AR: sensitivity (92% vs. 85%, P = 1.00), specificity (86% vs. 93%, P = 0.38), and accuracy (88% vs. 91%, P = 0.73). Inter- and intra-observer reproducibility was excellent. Furthermore, echo-derived distal HDFR showed descriptive consistency with CMR-derived HDFR in a small exploratory subgroup (n = 12; 92% agreement, κ = 0.82). Distal abdominal aortic DFR is a simple and highly feasible method for assessing AR severity, potentially overcoming the limitations of proximal DFR assessment in routine clinical practice.
SN - 2755-9637
ER -