To investigate the clinical and echocardiographic characteristics of aortic regurgitation caused by Takayasu arteritis (TA) and Behcet's disease (BD).

The clinical data of patients who were clinically diagnosed as having TA and BD and underwent surgical treatment due to aortic regurgitation (AR) at Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2002 to December 2016 were collected, including 25 patients with TA (TA group) and 23 patients with BD (BD group). The clinical and echocardiographic characteristics and postoperative complications of the two groups were compared and analyzed. The independent sample t-test and chi-square test were used for statistical analysis.

All the 25 patients with TA were correctly diagnosed before operation. Among the 23 patients with BD, 16 were correctly diagnosed before operation and 7 were diagnosed by clinicians after operation. In the TA group, there were 21 females (21/25, 84%) and 4 males. In the BD group, there were 4 females and 19 males (19/23, 83%). The difference in gender distribution between the two groups was statistically significant (P＜0.01). The erythrocyte sedimentation rate and C-reactive protein in the BD group were significantly higher than those in the TA group before operation (P＜0.05). In the BD group, preoperative echocardiography showed specific morphological manifestations of aortic valves: aortic valve prolapse with unusual aortic cusp thinning and redundancy in 16 patients, vegetation-mimicking mobile lesions from the aortic valve in 6, and annular echo-free spaces within the annulus in 6. In the TA group, echocardiography showed that there was no obvious specificity in the morphology of aortic valves. The diameter of the aortic root and ascending aorta in the TA group was significantly larger than that in the BD group (P＜0.05). During the follow-up period, 25 patients with TA had no complications, and 10 patients (43%) with BD had postoperative complications, including 10 cases of perivalvular leakage of aortic mechanical valve, 5 cases of aortic mechanical valve avulsion, 1 case of coronary anastomotic leakage, and 1 case of periaortic pseudoaneurysm.

The inflammatory damage of the aortic valve in BD patients with AR is more serious than that in TA patients. Echocardiography is very important for accurate preoperative evaluation of the cause of severe AR. Accurate preoperative diagnosis will help to change the treatment methods and reduce postoperative complications.