Aortic regurgitation causes: Difference between revisions

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==Overview==
==Overview==
Aortic insufficiency can be an [[acute]] illness or a [[chronic]] illness and the causes differ depending upon the acuity of the disease.  In general, aortic insufficiency is due to abnormalities of the [[aortic valve]] itself or the [[aortic root]].  Aortic regurgitation secondary to dilation of the [[ascending aorta]] has overtaken the valvular aortic disease as the most common cause of aortic regurgitation.
Aortic insufficiency can be an [[acute]] illness or a [[chronic]] illness and the causes differ depending upon the acuity of the disease.  In general, aortic insufficiency is due to abnormalities of the [[aortic valve]] itself or the [[aortic root]].  Aortic regurgitation secondary to dilation of the [[ascending aorta]] has overtaken the valvular aortic disease as the most common cause of aortic regurgitation.<ref name="Roman-1987">{{Cite journal  | last1 = Roman | first1 = MJ. | last2 = Devereux | first2 = RB. | last3 = Niles | first3 = NW. | last4 = Hochreiter | first4 = C. | last5 = Kligfield | first5 = P. | last6 = Sato | first6 = N. | last7 = Spitzer | first7 = MC. | last8 = Borer | first8 = JS. | title = Aortic root dilatation as a cause of isolated, severe aortic regurgitation. Prevalence, clinical and echocardiographic patterns, and relation to left ventricular hypertrophy and function. | journal = Ann Intern Med | volume = 106 | issue = 6 | pages = 800-7 | month = Jun | year = 1987 | doi =  | PMID = 2953289 }}</ref>


==Causes==
==Causes==
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**[[Marfan syndrome]]
**[[Marfan syndrome]]
**[[Osteogenesis imperfecta]]<ref name="Lamanna-2013">{{Cite journal  | last1 = Lamanna | first1 = A. | last2 = Fayers | first2 = T. | last3 = Clarke | first3 = S. | last4 = Parsonage | first4 = W. | title = Valvular and aortic diseases in osteogenesis imperfecta. | journal = Heart Lung Circ | volume = 22 | issue = 10 | pages = 801-10 | month = Oct | year = 2013 | doi = 10.1016/j.hlc.2013.05.640 | PMID = 23791715 }}</ref>
**[[Osteogenesis imperfecta]]<ref name="Lamanna-2013">{{Cite journal  | last1 = Lamanna | first1 = A. | last2 = Fayers | first2 = T. | last3 = Clarke | first3 = S. | last4 = Parsonage | first4 = W. | title = Valvular and aortic diseases in osteogenesis imperfecta. | journal = Heart Lung Circ | volume = 22 | issue = 10 | pages = 801-10 | month = Oct | year = 2013 | doi = 10.1016/j.hlc.2013.05.640 | PMID = 23791715 }}</ref>
**[[Pseudoxanthoma elasticum]]
**[[Pseudoxanthoma elasticum]]<ref name="COFFMAN-1959">{{Cite journal  | last1 = COFFMAN | first1 = JD. | last2 = SOMMERS | first2 = SC. | title = Familial pseudoxanthoma elasticum and valvular heart disease. | journal = Circulation | volume = 19 | issue = 2 | pages = 242-50 | month = Feb | year = 1959 | doi =  | PMID = 13629785 }}</ref>
*[[Hypertension]]
*[[Hypertension]]<ref name="Kim-1996">{{Cite journal  | last1 = Kim | first1 = M. | last2 = Roman | first2 = MJ. | last3 = Cavallini | first3 = MC. | last4 = Schwartz | first4 = JE. | last5 = Pickering | first5 = TG. | last6 = Devereux | first6 = RB. | title = Effect of hypertension on aortic root size and prevalence of aortic regurgitation. | journal = Hypertension | volume = 28 | issue = 1 | pages = 47-52 | month = Jul | year = 1996 | doi =  | PMID = 8675263 }}</ref>
*Inflammatory
*Inflammatory
**[[Ankylosing spondylitis]]<ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref>
**[[Ankylosing spondylitis]]<ref>Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.</ref>
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**[[Psoriatic arthritis]]
**[[Psoriatic arthritis]]
**[[Reiter's syndrome]]
**[[Reiter's syndrome]]
**[[Syphilitic aortitis]]
**[[Syphilitic aortitis]]<ref name="Aizawa-1998">{{Cite journal  | last1 = Aizawa | first1 = H. | last2 = Hasegawa | first2 = A. | last3 = Arai | first3 = M. | last4 = Naganuma | first4 = F. | last5 = Hatori | first5 = M. | last6 = Kanda | first6 = T. | last7 = Suzuki | first7 = T. | last8 = Murata | first8 = K. | last9 = Satoh | first9 = Y. | title = Bilateral coronary ostial stenosis and aortic regurgitation due to syphilitic aortitis. | journal = Intern Med | volume = 37 | issue = 1 | pages = 56-9 | month = Jan | year = 1998 | doi =  | PMID = 9510401 }}</ref>
*[[Traumatic aortic rupture]] following blunt chest trauma or deceleration injury
*[[Traumatic aortic rupture]] following blunt chest trauma or deceleration injury


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====Causes of Acute Aortic Insufficiency====
====Causes of Acute Aortic Insufficiency====
*After [[aortic valvuloplasty]].<ref name="pmid2016464">{{cite journal |author=Isner JM |title=Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators |journal=[[Journal of the American College of Cardiology]] |volume=17 |issue=6 |pages=1436–44 |year=1991 |month=May |pmid=2016464 |doi= |url= |accessdate=2011-03-28}}</ref>
*After [[aortic valvuloplasty]].<ref name="pmid2016464">{{cite journal |author=Isner JM |title=Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators |journal=[[Journal of the American College of Cardiology]] |volume=17 |issue=6 |pages=1436–44 |year=1991 |month=May |pmid=2016464 |doi= |url= |accessdate=2011-03-28}}</ref>
*A [[Aortic dissection classification#Stanford Classification System|type A aortic dissection]] may disrupt the integrity of the valve leaflets causing malcoaptation of the aortic leaflets.
*A [[Aortic dissection classification#Stanford Classification System|type A aortic dissection]] may disrupt the integrity of the valve leaflets causing malcoaptation of the aortic leaflets.<ref name="Lai-2003">{{Cite journal  | last1 = Lai | first1 = DT. | last2 = Miller | first2 = DC. | last3 = Mitchell | first3 = RS. | last4 = Oyer | first4 = PE. | last5 = Moore | first5 = KA. | last6 = Robbins | first6 = RC. | last7 = Shumway | first7 = NE. | last8 = Reitz | first8 = BA. | title = Acute type A aortic dissection complicated by aortic regurgitation: composite valve graft versus separate valve graft versus conservative valve repair. | journal = J Thorac Cardiovasc Surg | volume = 126 | issue = 6 | pages = 1978-86 | month = Dec | year = 2003 | doi = 10.1016/S0022 | PMID = 14688716 }}</ref>
*In [[bacterial endocarditis]] the [[infection]] can erode the valve and cause a leaflet to become flail, or a vegetation can prevent coaptation of the leaflets.
*In [[bacterial endocarditis]] the [[infection]] can erode the valve and cause a leaflet to become flail, or a vegetation can prevent coaptation of the leaflets.
*Blunt [[chest trauma]] can disrupt the supporting apparatus of the [[aortic valve]].
*Blunt [[chest trauma]] can disrupt the supporting apparatus of the [[aortic valve]].
*[[Myxomatous degeneration|Myxomatous aortic valve]] can degenerate, leading to insufficiency.
*[[Myxomatous degeneration|Myxomatous aortic valve]] can degenerate, leading to insufficiency.
*[[Prosthetic valve|Prosthetic valve dysfunction]]<ref>Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.</ref>
*[[Prosthetic valve|Prosthetic valve dysfunction]]<ref>Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.</ref>
*[[Rheumatic fever]]
*[[Rheumatic fever]]<ref name="Spagnuolo-1971">{{Cite journal  | last1 = Spagnuolo | first1 = M. | last2 = Kloth | first2 = H. | last3 = Taranta | first3 = A. | last4 = Doyle | first4 = E. | last5 = Pasternack | first5 = B. | title = Natural history of rheumatic aortic regurgitation. Criteria predictive of death, congestive heart failure, and angina in young patients. | journal = Circulation | volume = 44 | issue = 3 | pages = 368-80 | month = Sep | year = 1971 | doi =  | PMID = 4255488 }}</ref>
*Rupture of a [[Aortic valve#Disease of the aortic valve|congenitally fenestrated cusp]].<ref name="Stout-2009">{{Cite journal  | last1 = Stout | first1 = KK. | last2 = Verrier | first2 = ED. | title = Acute valvular regurgitation. | journal = Circulation | volume = 119 | issue = 25 | pages = 3232-41 | month = Jun | year = 2009 | doi = 10.1161/CIRCULATIONAHA.108.782292 | PMID = 19564568 }}</ref>
*Rupture of a [[Aortic valve#Disease of the aortic valve|congenitally fenestrated cusp]].<ref name="Stout-2009">{{Cite journal  | last1 = Stout | first1 = KK. | last2 = Verrier | first2 = ED. | title = Acute valvular regurgitation. | journal = Circulation | volume = 119 | issue = 25 | pages = 3232-41 | month = Jun | year = 2009 | doi = 10.1161/CIRCULATIONAHA.108.782292 | PMID = 19564568 }}</ref>


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*[[Takayasu arteritis]] can involve the [[aorta]] in an [[aortitis]], the [[aortic valve]] itself, and the [[coronary arteries]].<ref>Adachi O, Saiki Y, Akasaka J, Oda K, Iguchi A, Tabayashi K. Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis. Ann Thorac Surg. Dec 2007;84(6):1950-3.</ref>
*[[Takayasu arteritis]] can involve the [[aorta]] in an [[aortitis]], the [[aortic valve]] itself, and the [[coronary arteries]].<ref>Adachi O, Saiki Y, Akasaka J, Oda K, Iguchi A, Tabayashi K. Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis. Ann Thorac Surg. Dec 2007;84(6):1950-3.</ref>
*[[Turner's syndrome]]
*[[Turner's syndrome]]
*[[Ventricular septal defect]]
*[[Ventricular septal defect]]<ref name="Schmaltz-2004">{{Cite journal  | last1 = Schmaltz | first1 = AA. | last2 = Schaefer | first2 = M. | last3 = Hentrich | first3 = F. | last4 = Neudorf | first4 = U. | last5 = Brecher | first5 = AM. | last6 = Asfour | first6 = B. | last7 = Urban | first7 = AE. | title = [Ventricular septal defect and aortic regurgitation-pathophysiological aspects and therapeutic consequences]. | journal = Z Kardiol | volume = 93 | issue = 3 | pages = 194-200 | month = Mar | year = 2004 | doi = 10.1007/s00392-004-0015-2 | PMID = 15024586 }}</ref>
*[[Weight loss]] medications including [[fenfluramine]] and [[dexfenfluramine]] (a.k.a. [[Phen-Fen]]).  These drugs have been associated with degeneration of the aortic valve.
*[[Weight loss]] medications including [[fenfluramine]] and [[dexfenfluramine]] (a.k.a. [[Phen-Fen]]).  These drugs have been associated with degeneration of the aortic valve.
* [[Whipple disease]] can involve the aortic valve.<ref>Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.</ref>
* [[Whipple disease]] can involve the aortic valve.<ref>Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.</ref>
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===Common Causes===
===Common Causes===
*Worldwide the most common cause of aortic insufficiency is the [[rheumatic heart disease]].
*Worldwide the most common cause of aortic insufficiency is the [[rheumatic heart disease]].<ref name="Bekeredjian-2005">{{Cite journal  | last1 = Bekeredjian | first1 = R. | last2 = Grayburn | first2 = PA. | title = Valvular heart disease: aortic regurgitation. | journal = Circulation | volume = 112 | issue = 1 | pages = 125-34 | month = Jul | year = 2005 | doi = 10.1161/CIRCULATIONAHA.104.488825 | PMID = 15998697 }}</ref>
*In the United States, [[senile]] degenerative [[calcific aortic valve disease]] and [[bicuspid aortic valve]] disease are the most common causes.
*In the United States, [[Calcific aortic valve disease|senile or degenerative calcific aortic valve disease]] and [[bicuspid aortic valve]] disease are the most common causes.<ref name="Nishimura-2002">{{Cite journal  | last1 = Nishimura | first1 = RA. | title = Cardiology patient pages. Aortic valve disease. | journal = Circulation | volume = 106 | issue = 7 | pages = 770-2 | month = Aug | year = 2002 | doi =  | PMID = 12176943 }}</ref>
*Aortic regurgitation secondary to dilation of the [[ascending aorta]] has overtaken valvular aortic disease as the most common cause of aortic regurgitation.
*Aortic regurgitation secondary to dilation of the [[ascending aorta]] has overtaken valvular aortic disease as the most common cause of aortic regurgitation.
*In general, aortic insufficiency is due to abnormalities of the [[aortic valve]] itself or the [[aortic root]].
*In general, aortic insufficiency is due to abnormalities of the [[aortic valve]] itself or the [[aortic root]].
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[antiphospholipid syndrome]], [[Bechterew's Disease|Bechterew's disease]], [[Behcet disease]], [[collagen vascular disease]], [[Cystic medial necrosis]], [[Ehlers-Danlos syndrome]], [[giant cell arteritis]], [[inflammatory bowel disease]], [[Marfan syndrome]], [[Myxomatous degeneration|myxomatous aortic valve]], [[osteogenesis imperfecta]], [[polymyalgia rheumatica]], [[pseudoxanthoma elasticum]], [[psoriatic arthritis]], [[reactive arthritis]], [[Reiter's syndrome]], [[relapsing polychondritis]], [[rheumatic fever]], [[rheumatoid arthritis]], [[sarcoidosis]], [[spondyloarthropathy]], [[systemic lupus erythematosus]], [[Takayasu arteritis]], [[ulcerative colitis]], [[Whipple disease]]
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[antiphospholipid syndrome]], [[Bechterew's Disease|Bechterew's disease]], [[Behcet disease]], [[collagen vascular disease]], [[cystic medial necrosis]], [[Ehlers-Danlos syndrome]], [[giant cell arteritis]], [[inflammatory bowel disease]], [[Marfan syndrome]], [[Myxomatous degeneration|myxomatous aortic valve]], [[osteogenesis imperfecta]], [[polymyalgia rheumatica]], [[pseudoxanthoma elasticum]], [[psoriatic arthritis]], [[reactive arthritis]], [[Reiter's syndrome]], [[relapsing polychondritis]], [[rheumatic fever]], [[rheumatoid arthritis]], [[sarcoidosis]], [[spondyloarthropathy]], [[systemic lupus erythematosus]], [[Takayasu arteritis]], [[ulcerative colitis]], [[Whipple disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"|  Blunt [[chest trauma]] disrupting the supporting apparatus of the [[aortic valve]]
|bgcolor="Beige"|  [[Chest trauma]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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*[[Phentermine]]
*[[Phentermine]]
*[[Polymyalgia rheumatica]]
*[[Polymyalgia rheumatica]]
*[[Prosthetic valve|Prosthetic valve dysfunction]]
*[[Prosthetic valve|Prosthetic valve dysfunction]]<ref name="Mullenix-2008">{{Cite journal  | last1 = Mullenix | first1 = PS. | last2 = Parsa | first2 = CJ. | last3 = Mackensen | first3 = GB. | last4 = Jollis | first4 = JG. | last5 = Harrison | first5 = JK. | last6 = Hughes | first6 = GC. | title = Pannus-related prosthetic valve dysfunction and life-threatening aortic regurgitation. | journal = J Heart Valve Dis | volume = 17 | issue = 6 | pages = 666-9 | month = Nov | year = 2008 | doi =  | PMID = 19137799 }}</ref>
*[[Pseudoxanthoma elasticum]]
*[[Pseudoxanthoma elasticum]]
*[[Psoriatic arthritis]]
*[[Psoriatic arthritis]]

Revision as of 20:25, 21 November 2013

Aortic Regurgitation Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.; Vendhan Ramanujam M.B.B.S [3]

Overview

Aortic insufficiency can be an acute illness or a chronic illness and the causes differ depending upon the acuity of the disease. In general, aortic insufficiency is due to abnormalities of the aortic valve itself or the aortic root. Aortic regurgitation secondary to dilation of the ascending aorta has overtaken the valvular aortic disease as the most common cause of aortic regurgitation.[1]

Causes

Causes of Aortic Insufficiency as of Site of Diseases

Aortic Valve Diseases

Aortic Root Diseases

Causes of Aortic Insufficiency as of Type of Onset

Causes of Acute Aortic Insufficiency

Causes of Chronic Aortic Insufficiency

Complete Differential Diagnosis for the Causes of Aortic Insufficiency

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Annuloaortic ectasia, aortic valvuloplasty, aortic dissection, arterial tortuosity syndrome, bacterial endocarditis, balloon valvotomy, bicuspid aortic valve, congenitally fenestrated cusp rupture, cystic medial necrosis, hypertension, prosthetic valve dysfunction, senile aortic ectasia and dilation, senile or degenerative calcific aortic valve disease, sinus of valsalva aneurysm, subaortic stenosis, subpulmonic ventricular septal defect, tetralogy of fallot, thoracic aortic aneurysm, unicuspid aortic valve, ventricular septal defect
Chemical / poisoning No underlying causes
Dermatologic Psoriatic arthritis
Drug Side Effect Cabergoline, dexfenfluramine, dopamine agonists, fenfluramine, methysergide, pergolide, phentermine
Ear Nose Throat No underlying causes
Endocrine Acromegaly
Environmental No underlying causes
Gastroenterologic Inflammatory bowel disease, ulcerative colitis, Whipple disease
Genetic Ankylosing spondylitis, autosomal dominant polycystic kidney disease, bicuspid aortic valve, down syndrome, Ehlers-Danlos syndrome, Hurler syndrome, Marfan syndrome, Maroteaux-Lamy syndrome, mucolipidosis II alpha/beta, mucolipidosis III gamma, mucopolysaccharidosis, mucopolysaccharidosis type I Hurler/Scheie syndrome, osteogenesis imperfecta, pseudoxanthoma elasticum, Reiter's syndrome, Rheumatoid arthritis, Scheie syndrome, Shprintzen-Goldberg syndrome, systemic lupus erythematosus, Takayasu arteritis, truncus arteriosus, Turner's syndrome
Hematologic No underlying causes
Iatrogenic Aortic valvuloplasty, balloon valvotomy, double switch operation, prosthetic valve dysfunction, radiation, Senning-Rastelli procedure
Infectious Disease Bacterial endocarditis, perivalvular abscess, Q fever, rheumatic fever, syphilis
Musculoskeletal / Ortho Ankylosing spondylitis, collagen vascular disease, Ehlers-Danlos syndrome, osteogenesis imperfecta, psoriatic arthritis, Reiter's Syndrome, relapsing polychondritis, rheumatoid arthritis, spondyloarthropathy, systemic lupus erythematosus
Neurologic No underlying causes
Nutritional / Metabolic Mucolipidosis II alpha/beta, mucolipidosis III gamma
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte Autosomal dominant polycystic kidney disease
Rheum / Immune / Allergy Ankylosing spondylitis, antiphospholipid syndrome, Bechterew's disease, Behcet disease, collagen vascular disease, cystic medial necrosis, Ehlers-Danlos syndrome, giant cell arteritis, inflammatory bowel disease, Marfan syndrome, myxomatous aortic valve, osteogenesis imperfecta, polymyalgia rheumatica, pseudoxanthoma elasticum, psoriatic arthritis, reactive arthritis, Reiter's syndrome, relapsing polychondritis, rheumatic fever, rheumatoid arthritis, sarcoidosis, spondyloarthropathy, systemic lupus erythematosus, Takayasu arteritis, ulcerative colitis, Whipple disease
Sexual Syphilis
Trauma Chest trauma
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. ↑ Roman, MJ.; Devereux, RB.; Niles, NW.; Hochreiter, C.; Kligfield, P.; Sato, N.; Spitzer, MC.; Borer, JS. (1987). "Aortic root dilatation as a cause of isolated, severe aortic regurgitation. Prevalence, clinical and echocardiographic patterns, and relation to left ventricular hypertrophy and function". Ann Intern Med. 106 (6): 800–7. PMID 2953289. Unknown parameter |month= ignored (help)
  2. ↑ Roberts, WC.; Vowels, TJ.; Ko, JM. (2012). "Natural history of adults with congenitally malformed aortic valves (unicuspid or bicuspid)". Medicine (Baltimore). 91 (6): 287–308. doi:10.1097/MD.0b013e3182764b84. PMID 23117850. Unknown parameter |month= ignored (help)
  3. ↑ Wunderlich, C.; Schulze, MR.; Strasser, RH. (2005). "Severe aortic regurgitation in Ehlers-Danlos syndrome type IV". Heart. 91 (1): 126. doi:10.1136/hrt.2004.035097. PMID 15604357. Unknown parameter |month= ignored (help)
  4. ↑ Brown, OR.; DeMots, H.; Kloster, FE.; Roberts, A.; Menashe, VD.; Beals, RK. (1975). "Aortic root dilatation and mitral valve prolapse in Marfan's syndrome: an ECHOCARDIOgraphic study". Circulation. 52 (4): 651–7. PMID 1157278. Unknown parameter |month= ignored (help)
  5. ↑ Levine, AJ.; Dimitri, WR.; Bonser, RS. (1999). "Aortic regurgitation in rheumatoid arthritis necessitating aortic valve replacement". Eur J Cardiothorac Surg. 15 (2): 213–4. PMID 10219558. Unknown parameter |month= ignored (help)
  6. ↑ Miyashita, T.; Abe, Y.; Kato, Y.; Nakagawa, E.; Komatsu, R.; Hattori, K.; Shibata, T.; Yoshioka, K.; Naruko, T. (2010). "Aortic aneurysm with severe aortic regurgitation in a patient with systemic lupus erythematosus". Intern Med. 49 (20): 2263–6. PMID 20962447.
  7. ↑ Schade R, Andersohn F, Suissa S, Haverkamp W, Garbe E (2007). "Dopamine agonists and the risk of cardiac-valve regurgitation". The New England Journal of Medicine. 356 (1): 29–38. doi:10.1056/NEJMoa062222. PMID 17202453. Retrieved 2011-03-28. Unknown parameter |month= ignored (help)
  8. ↑ Rothman RB, Baumann MH, Savage JE, Rauser L, McBride A, Hufeisen SJ, Roth BL (2000). "Evidence for possible involvement of 5-HT(2B) receptors in the cardiac valvulopathy associated with fenfluramine and other serotonergic medications". Circulation. 102 (23): 2836–41. PMID 11104741. Retrieved 2011-03-28. Unknown parameter |month= ignored (help)
  9. ↑ Waller EA, Kaplan J, Heckman MG (2005). "Valvular heart disease in patients taking pergolide". Mayo Clinic Proceedings. Mayo Clinic. 80 (8): 1016–20. PMID 16092580. Retrieved 2011-03-28. Unknown parameter |month= ignored (help)
  10. ↑ 10.0 10.1 Jollis, JG.; Landolfo, CK.; Kisslo, J.; Constantine, GD.; Davis, KD.; Ryan, T. (2000). "Fenfluramine and phentermine and cardiovascular findings: effect of treatment duration on prevalence of valve abnormalities". Circulation. 101 (17): 2071–7. PMID 10790349. Unknown parameter |month= ignored (help)
  11. ↑ Pereira, AM.; van Thiel, SW.; Lindner, JR.; Roelfsema, F.; van der Wall, EE.; Morreau, H.; Smit, JW.; Romijn, JA.; Bax, JJ. (2004). "Increased prevalence of regurgitant valvular heart disease in acromegaly". J Clin Endocrinol Metab. 89 (1): 71–5. PMID 14715829. Unknown parameter |month= ignored (help)
  12. ↑ Stiles, GL.; Friesinger, GC. (1980). "Bacterial endocarditis with aortic regurgitation: implications of embolism". South Med J. 73 (5): 582–6. PMID 7375973. Unknown parameter |month= ignored (help)
  13. ↑ 13.0 13.1 Spagnuolo, M.; Kloth, H.; Taranta, A.; Doyle, E.; Pasternack, B. (1971). "Natural history of rheumatic aortic regurgitation. Criteria predictive of death, congestive heart failure, and angina in young patients". Circulation. 44 (3): 368–80. PMID 4255488. Unknown parameter |month= ignored (help)
  14. ↑ Lamanna, A.; Fayers, T.; Clarke, S.; Parsonage, W. (2013). "Valvular and aortic diseases in osteogenesis imperfecta". Heart Lung Circ. 22 (10): 801–10. doi:10.1016/j.hlc.2013.05.640. PMID 23791715. Unknown parameter |month= ignored (help)
  15. ↑ COFFMAN, JD.; SOMMERS, SC. (1959). "Familial pseudoxanthoma elasticum and valvular heart disease". Circulation. 19 (2): 242–50. PMID 13629785. Unknown parameter |month= ignored (help)
  16. ↑ Kim, M.; Roman, MJ.; Cavallini, MC.; Schwartz, JE.; Pickering, TG.; Devereux, RB. (1996). "Effect of hypertension on aortic root size and prevalence of aortic regurgitation". Hypertension. 28 (1): 47–52. PMID 8675263. Unknown parameter |month= ignored (help)
  17. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  18. ↑ Aizawa, H.; Hasegawa, A.; Arai, M.; Naganuma, F.; Hatori, M.; Kanda, T.; Suzuki, T.; Murata, K.; Satoh, Y. (1998). "Bilateral coronary ostial stenosis and aortic regurgitation due to syphilitic aortitis". Intern Med. 37 (1): 56–9. PMID 9510401. Unknown parameter |month= ignored (help)
  19. ↑ Isner JM (1991). "Acute catastrophic complications of balloon aortic valvuloplasty. The Mansfield Scientific Aortic Valvuloplasty Registry Investigators". Journal of the American College of Cardiology. 17 (6): 1436–44. PMID 2016464. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  20. ↑ Lai, DT.; Miller, DC.; Mitchell, RS.; Oyer, PE.; Moore, KA.; Robbins, RC.; Shumway, NE.; Reitz, BA. (2003). "Acute type A aortic dissection complicated by aortic regurgitation: composite valve graft versus separate valve graft versus conservative valve repair". J Thorac Cardiovasc Surg. 126 (6): 1978–86. doi:10.1016/S0022. PMID 14688716. Unknown parameter |month= ignored (help)
  21. ↑ Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.
  22. ↑ Stout, KK.; Verrier, ED. (2009). "Acute valvular regurgitation". Circulation. 119 (25): 3232–41. doi:10.1161/CIRCULATIONAHA.108.782292. PMID 19564568. Unknown parameter |month= ignored (help)
  23. ↑ Palazzi C, D' Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. May-Jun 2008;26(3 Suppl 49):S131-4.
  24. ↑ Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. Feb 2008;6(2):235-48.
  25. ↑ Eberhardt RT, Dhadly M. Giant cell arteritis: diagnosis, management, and cardiovascular implications. Cardiol Rev. Mar-Apr 2007;15(2):55-61.
  26. ↑ Chand EM, Freant LJ, Rubin JW. Aortic valve rheumatoid nodules producing clinical aortic regurgitation and a review of the literature. Cardiovasc Pathol. Nov-Dec 1999;8(6):333-8.
  27. ↑ Jain D, Halushka MK. Cardiac pathology of systemic lupus erythematosus. J Clin Pathol. Jul 2009;62(7):584-92.
  28. ↑ Moyssakis I, Tektonidou MG, Vasilliou VA, Samarkos M, Votteas V, Moutsopoulos HM. Libman-Sacks endocarditis in systemic lupus erythematosus: prevalence, associations, and evolution. Am J Med. Jul 2007;120(7):636-42.
  29. ↑ Lee JL, Naguwa SM, Cheema GS, Gershwin ME. Revisiting Libman-Sacks endocarditis: a historical review and update. Clin Rev Allergy Immunol. Jun 2009;36(2-3):126-30.
  30. ↑ Adachi O, Saiki Y, Akasaka J, Oda K, Iguchi A, Tabayashi K. Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis. Ann Thorac Surg. Dec 2007;84(6):1950-3.
  31. ↑ Schmaltz, AA.; Schaefer, M.; Hentrich, F.; Neudorf, U.; Brecher, AM.; Asfour, B.; Urban, AE. (2004). "[Ventricular septal defect and aortic regurgitation-pathophysiological aspects and therapeutic consequences]". Z Kardiol. 93 (3): 194–200. doi:10.1007/s00392-004-0015-2. PMID 15024586. Unknown parameter |month= ignored (help)
  32. ↑ Jeserich M, Ihling C, Holubarsch C. Aortic valve endocarditis with Whipple disease. Ann Intern Med. Jun 1 1997;126(11):920.
  33. ↑ Bekeredjian, R.; Grayburn, PA. (2005). "Valvular heart disease: aortic regurgitation". Circulation. 112 (1): 125–34. doi:10.1161/CIRCULATIONAHA.104.488825. PMID 15998697. Unknown parameter |month= ignored (help)
  34. ↑ Nishimura, RA. (2002). "Cardiology patient pages. Aortic valve disease". Circulation. 106 (7): 770–2. PMID 12176943. Unknown parameter |month= ignored (help)
  35. ↑ Mullenix, PS.; Parsa, CJ.; Mackensen, GB.; Jollis, JG.; Harrison, JK.; Hughes, GC. (2008). "Pannus-related prosthetic valve dysfunction and life-threatening aortic regurgitation". J Heart Valve Dis. 17 (6): 666–9. PMID 19137799. Unknown parameter |month= ignored (help)

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