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Pathophysiology of the aortic regurgitation Doppler signal end‐diastolic notching: “A‐dip insight”
Author(s) -
Giannakopoulos Georgios,
Rey Florian,
Müller Hajo
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14774
Subject(s) - cardiology , medicine , diastole , regurgitation (circulation) , heart failure , ejection fraction , doppler echocardiography , contractility , blood pressure
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.