From the Guidelines
In patients with aortic regurgitation, the interventricular septum (IVS) typically exhibits a diastolic fluttering motion. This characteristic motion is a result of the regurgitant jet of blood flowing backward from the aorta into the left ventricle during diastole, striking the anterior leaflet of the mitral valve and the adjacent interventricular septum, causing them to vibrate or flutter 1. The severity of the fluttering often correlates with the degree of aortic regurgitation, with more pronounced fluttering seen in cases of severe regurgitation. Some key points to consider in the context of aortic regurgitation and IVS motion include:
- The El Khoury functional classification can be helpful to appraise the mechanism of AR, guide valve repair technique, and predict recurrence of AR 1
- Volume overload imposed by significant AR leads to increased total stroke volume, resulting in systolic hypertension and afterload mismatch 1
- The diastolic fluttering motion of the IVS serves as an important diagnostic clue when evaluating patients with suspected aortic valve disease, especially when combined with other clinical and echocardiographic findings such as a widened pulse pressure, diastolic murmur, or visualization of the regurgitant jet on color Doppler imaging. Given the significant cardiovascular morbidity and mortality associated with severe AR, early detection and accurate diagnosis are crucial to improve patient outcomes 1.