Aortic Regurgitation — Beyond the Valve

Guest: Vidhu Anand, M.B.B.S. Host: Kyle Klarich, M.D.  In this episode of Mayo Clinic’s “Interviews With the Experts,” Dr. Klarich and Dr. Anand discuss evolving approaches to assessing left ventricular remodeling in chronic aortic regurgitation. Dr. Vidhu Anand discusses research showing that LV volumes, global longitudinal strain, and myocardial fibrosis can detect dysfunction earlier than traditional guideline thresholds. Listeners can expect to better understand the role of multimodality imaging, extra valvular involvement, and practical steps echocardiographers can take to optimize AR assessment.  Topics Discussed: • What imaging markers help detect early myocardial dysfunction in AR, and how do they assist in risk stratification? • Guidelines traditionally focus on LV dimensions and ejection fraction for surgical decision-making in AR. Is there any data that guidelines may not be capturing patients at the optimal time? • Is there a role of multimodality imaging in AR? • What practical steps can a sonographer or echocardiographer take today to bring their AR assessment closer to what your research suggests is optimal? 0:00 Introduction and Overview 1:45 What is Aortic Regurgitation (AR)? — definition and basic mechanism 4:20 Causes / Risk Factors — why AR happens 7:00 Physiological Effects and Pathophysiology — what AR does to the heart/body 10:35 Symptoms and Clinical Presentation 13:10 Diagnosis and Assessment — how AR is identified (imaging, signs, etc.) 16:00 Treatment Options — medical management, surgical repair/replacement 19:45 Prognosis and Follow-up — what to expect long-term