The reference values below are taken from the consensus documents of the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI). Use the table of contents to go straight to the relevant section.
Aorta, normal values
| Normal range | Normal range, indexed |
|---|
| Aortic annulus | 20-31 mm | 12-14 mm/m2 |
| Sinuses of Valsalva | 29-45 mm | 15-20 mm/m2 |
| Sinotubular junction | 22-36 mm | 13-17 mm/m2 |
| Ascending aorta | 22-36 mm | 13-17 mm/m2 |
| Aortic arch | 22-36 mm | |
| Descending aorta | 20-30 mm | |
Indexing means that the value is adjusted for body surface area (BSA), given in square metres.
Aorta, standardised values
Standardised values (mean ± SD)
| Age | Aortic annulus, women | Aortic annulus, men | Sinuses of Valsalva, women | Sinuses of Valsalva, men |
|---|
| <30 | 11.4 ± 1.1 | 11.4 ± 1.2 | 15.5 ± 1.5 | 15.3 ± 1.8 |
| 30–39 | 11.7 ± 1.0 | 11.4 ± 1.1 | 16.5 ± 1.6 | 15.7 ± 1.3* |
| 40–49 | 11.7 ± 1.0 | 11.5 ± 0.9 | 16.8 ± 1.4 | 16.6 ± 1.5 |
| 50–59 | 12.0 ± 0.9 | 11.5 ± 0.9 | 17.9 ± 1.6 | 16.8 ± 1.7* |
| 60–69 | 11.7 ± 1.1 | 12.1 ± 1.0 | 17.5 ± 1.7 | 17.8 ± 1.6 |
| >70 | 11.6 ± 1.1 | 12.0 ± 1.0 | 18.2 ± 1.9 | 18.1 ± 1.7 |
| All | 11.7 ± 1.0 | 11.6 ± 1.0 | 17.0 ± 1.9 | 16.6 ± 1.8 |
| Age | Sinotubular junction, women | Sinotubular junction, men | Ascending aorta, women | Ascending aorta, men |
|---|
| <30 | 13.5 ± 1.4 | 12.7 ± 2.3 | 15.1 ± 1.6 | 14.3 ± 1.6* |
| 30–39 | 14.3 ± 1.5 | 13.3 ± 1.3 | 16.4 ± 1.8 | 14.5 ± 1.4* |
| 40–49 | 14.6 ± 1.2 | 14.1 ± 1.5* | 16.4 ± 1.4 | 15.5 ± 1.5* |
| 50–59 | 15.7 ± 1.3 | 14.1 ± 1.5 | 18.0 ± 1.4 | 16.2 ± 1.6* |
| 60–69 | 14.7 ± 1.6 | 15.1 ± 1.6* | 17.6 ± 1.7 | 17.3 ± 1.7 |
| >70 | 15.5 ± 2.0 | 14.7 ± 1.6 | 18.2 ± 3.3 | 17.5 ± 1.4 |
| All | 14.7 ± 1.7 | 13.9 ± 1.8 | 16.9 ± 2.3 | 15.7 ± 1.8 |
| Age | Aortic arch, women | Aortic arch, men |
|---|
| <30 | 10.7 ± 1.0 | 10.1 ± 1.3* |
| 30–39 | 11.6 ± 1.6 | 10.8 ± 1.3* |
| 40–49 | 11.5 ± 1.2 | 11.3 ± 1.3 |
| 50–59 | 12.7 ± 1.1 | 11.3 ± 1.2* |
| 60–69 | 12.5 ± 1.4 | 12.0 ± 1.1 |
| >70 | 12.7 ± 1.2 | 12.2 ± 1.3 |
| All | 11.9 ± 1.5 | 11.2 ± 1.4 |
Aortic regurgitation (AR)
Primary parameters
| Mild regurgitation | Moderate regurgitation | Severe regurgitation |
|---|
| Vena contracta (cm) | < 0.3 | 0.3-0.6 | > 0.6 |
| PHT (pressure half time) – CW doppler | > 500 | 200-500 | < 200 |
| Diastolic flow reversal – PW doppler aorta descendens | if present, early diastolic | early diastolic | holodiastolic |
Quantification of jet
| Mild regurgitation | Moderate regurgitation | Severe regurgitation |
|---|
| Jet-width / LVOT-width | < 0.25 | 0.25-0.64 | > 0.64 |
| Jet-area / LVOT-area | < 0.05 | 0.05-0.59 | > 0.59 |
Qualitative parameters
| Mild regurgitation | Moderate regurgitation | Severe regurgitation |
|---|
| Jet area | small | variable | large if central, variable if excentric |
| Coaptation defect | mild | moderate | severe |
| CW-profile aortic regurgitation | weak | variable | dense |
| Size left atrium | normal | normal or enlarged | enlarged |
| Size left ventricle | normal | normal or enlarged | enlarged |
Additional PISA-parameters
| Mild regurgitation | Moderate regurgitation | Severe regurgitation |
|---|
| EROA (cm²) | < 0.10 | 0.10-0.29 | > 0.29 |
| Regurgitation volume (ml/beat) | < 30 | 30-59 | > 59 |
| Regurgitation fraction (%) | < 30 | 30-49 | > 49 |
EROA = (CSA*v)/v(maxMR) {{ Flow rate = CSA*v = 6.28*r2*v(aliasing)
References
- Zoghbi, William A.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A.; Kraft, Carol D.; Levine, Robert A. et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 16 (7), pp. 777–802. DOI: 10.1016/S0894-7317(03)00335-3.
- Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A. et al. (2017): Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation. A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007.
Aortic stenosis (AS)
Disease defining parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Valve area (cm²) | > 1.5 | 1.0-1.5 | < 1.0 |
| Normalized valve area (cm²/m²) | >0.85 | 0.6-0.85 | < 0.6 |
Measured parameters
| Aortic sclerosis | Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Mean gradient (mmHg) | | < 20 | 20-40 | > 40 |
| Peak velocity (m/s) | 1.8-2.5 | 2.6-2.9 | 3.0-4.0 | > 4.0 |
| Peak gradient (mmHg) | | < 35 | 35-65 | > 65 |
| Velocity ratio (LVOT / aotric valve) | | > 0.5 | 0.5-0.25 | < 0.25 |
References
- Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 22 (1), 1-23; quiz 101-2. DOI: 10.1016/j.echo.2008.11.029.
- Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 10 (1), pp. 1–25. DOI: 10.1093/ejechocard/jen303.
- Vahanian, Alec; Alfieri, Ottavio; Andreotti, Felicita; Antunes, Manuel J.; Barón-Esquivias, Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451–2496. DOI: 10.1093/eurheartj/ehs109.
- Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Edvardsen, Thor; Goldstein, Steven et al. (2017): Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis. A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp. 372–392. DOI: 10.1016/j.echo.2017.02.009.
Left ventricle, systolic function, visual assessment
Visual assessment of the left ventricular segments (systolic function)
| TYPE OF WALL MOTION | DEFINITION | WALL MOTION SCORE |
|---|
| Normal | Normal thickening (usually > 30 % thickening from end-diastole to end-systole). | 1 |
| Hypokinesis | Reduced thickening (usually 10–30 % thickening from end-diastole to end-systole) | 2 |
| Akinesis | Markedly reduced or absent thickening (< 10 %) | 3 |
| Dyskinesis | Paradoxical thinning and/or outward movement during systole | 4 |
| Aneurysmal | Diastolic deformation | 5 |
This semiquantitative grading of left ventricular systolic function is recommended by the American Society of Echocardiography (J Am Soc Echocardiogr 18:1440-1463, 2005).
Left ventricle, mass and geometry
Reference values for left ventricular mass and geometry
| Women | | | | Men | | | |
|---|
| Reference | Mildly abnormal | Moderately abnormal | Severely abnormal | Reference | Mildly abnormal | Moderately abnormal | Severely abnormal |
| LINEAR METHOD | | | | | | | | |
| LV mass, g | 67–162 | 163–186 | 187–210 | >211 | 88–224 | 225–258 | 259–292 | >293 |
| LV mass/BSA, g/m2 | 43–95 | 96–108 | 109–121 | > 122 | 49–115 | 116–131 | 132–148 | > 149 |
| LV mass/height, g/m | 41–99 | 100–115 | 116–128 | >129 | 52–126 | 127–144 | 145–162 | >163 |
| LV mass/height 2.7 , g/m2.7 | 18–44 | 45–51 | 52–58 | >59 | 20–48 | 49–55 | 56–63 | >64 |
| Relative wall thickness, cm | 0.22–0.42 | 0.43–0.47 | 0.48–0.52 | >0.53 | 0.24–0.42 | 0.43–0.46 | 0.47–0.51 | >0.52 |
| Septal thickness, cm | 0.6–0.9 | 1.0–1.2 | 1.3–1.5 | > 1.6 | 0.6–1.0 | 1.1–1.3 | 1.4–1.6 | > 1.7 |
| Posterior wall thickness, cm | 0.6–0.9 | 1.0–1.2 | 1.3–1.5 | > 1.6 | 0.6–1.0 | 1.1–1.3 | 1.4–1.6 | > 1.7 |
| 2D METHOD | | | | | | | | |
| LV mass, g | 66–150 | 151–171 | 172–182 | > 193 | 96–200 | 201–227 | 228–254 | > 255 |
| LV mass/BSA, g/m2 | 44–88 | 89–100 | 101–112 | > 113 | 50–102 | 103–116 | 117–130 | > 131 |
BSA, Body surface area; LV, left ventricular; 2D, 2-dimensional. Bold italic: recommended and best validated.
Left ventricle, size
Reference values for left ventricular size
| Women | | | | Men | | | |
|---|
| Normal range | Mildly abnormal | Moderately abnormal | Severely abnormal | Normal range | Mildly abnormal | Moderately abnormal | Severely abnormal |
| LV DIMENSIONS | | | | | | | | |
| LV diastolic diameter | 3.9–5.3 | 5.4–5.7 | 5.8–6.1 | >6.2 | 4.2–5.9 | 6.0–6.3 | 6.4–6.8 | >6.9 |
| LV diastolic diameter/BSA, cm/m 2 | 2.4–3.2 | 3.3–3.4 | 3.5–3.7 | >3.8 | 2.2–3.1 | 3.2–3.4 | 3.5–3.6 | >3.7 |
| LV diastolic diameter/height, cm/m | 2.5–3.2 | 3.3–3.4 | 3.5–3.6 | >3.7 | 2.4–3.3 | 3.4–3.5 | 3.6–3.7 | >3.8 |
| LV VOLUME | | | | | | | | |
| LV diastolic volume, mL | 56–104 | 105–117 | 118–130 | >131 | 67–155 | 156–178 | 179–201 | >201 |
| LV diastolic volume/BSA, mL/m 2 | 35–75 | 76–86 | 87–96 | > 97 | 35–75 | 76–86 | 87–96 | > 97 |
| LV systolic volume, mL | 19–49 | 50–59 | 60–69 | >70 | 22–58 | 59–70 | 71–82 | >83 |
| LV systolic volume/BSA, mL/m 2 | 12–30 | 31–36 | 37–42 | > 43 | 12–30 | 31–36 | 37–42 | > 43 |
BSA, body surface area; LV, left ventricular. Bold italic: recommended and best validated.
Left ventricle, function
Reference values for left ventricular function
| Women | | | | Men | | | |
|---|
| Normal | Mildly abnormal | Moderately abnormal | Severely abnormal | Normal | Mildly abnormal | Moderately abnormal | Severely abnormal |
| LINEAR METHOD | | | | | | | | |
| Endocardial fractional shortening, % | 27–45 | 22–26 | 17–21 | <16 | 25–43 | 20–24 | 15–19 | <14 |
| Midwall fractional shortening, % | 15–23 | 13–14 | 11–12 | <10 | 14–22 | 12–13 | 10–11 | <10 |
| 2D METHOD | | | | | | | | |
| Ejection fraction, % | >55 | 45–54 | 30–44 | <30 | >55 | 45–54 | 30–44 | <30 |
2D, Two-dimensional. Bold italic: recommended and best validated.
New classification of ejection fraction
| Normal | Mildly abnormal | Moderately abnormal | Severely abnormal |
|---|
| Ejection fraction (%), biplan, males | 52-72 | 41-51 | 30-40 | <30 |
| Ejection fraction (%), biplan, females | 54-74 | 41-53 | 30-40 | <30 |
References
- Lang, Roberto M.; Badano, Luigi P.; Mor-Avi, Victor; Afilalo, Jonathan; Armstrong, Anderson; Ernande, Laura et al. (2015): Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. In European heart journal cardiovascular Imaging 16 (3), pp. 233–270. DOI: 10.1093/ehjci/jev014.
- Lang, Roberto M.; Bierig, Michelle; Devereux, Richard B.; Flachskampf, Frank A.; Foster, Elyse; Pellikka, Patricia A. et al. (2005): Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 18 (12), pp. 1440–1463. DOI: 10.1016/j.echo.2005.10.005. –>Pubmed-Link
Left ventricle, diastolic function
| Criteria | Normal, young | Normal, adult | Impaired relaxation (grade 1 dysfunction) | Pseudonormal (grade 2 dysfunction) | Reversible restrictive filling (grade 3 dysfunction) | Irreversible restrictive filling (grade 4 dysfunction) |
|---|
| E/A-ratio | 1–2 | 1–2 | <1 | 1–1.5 (reverses with the Valsalva manoeuvre) | >1.5 | 1.5–2.0 (does not reverse with the Valsalva manoeuvre) |
| Deceleration time (DT), ms | <240 | 150–240 | ≥240 | 150–200 | <150 | <150 |
| IVRT (ms) | 70–90 | 70–90 | >90 | <90 | <70 | <70 |
| S/D-ratio | <1 | ≥1 | ≥1 | <1 | <1 | <1 |
| ARdur – Adur (ms) | ≥30 | ≤0 | ≤0 or ≥30 | ≥30 | ≥30 | ≥30 |
| AR velocity (cm/s) | <35 | <35 | <35 | ≥35 | ≥35 | ≥35 |
| e’ velocity (cm/s) | >10 | >8 | <8 | <8 | <8 | <8 |
“ARdur–Adur” is obtained by subtracting Adur from ARdur. The AR velocity is the flow velocity of the negative wave recorded on pulmonary vein Doppler (AR = atrial reversal).
Right ventricle and pulmonary artery
| Normal range | Mildly abnormal | Moderately abnormal | Severely abnormal |
|---|
| RV DIMENSIONS | | | | |
| Basal RV diameter (RVD 1), cm | 2.0–2.8 | 2.9–3.3 | 3.4–3.8 | >3.9 |
| Mid RV diameter (RVD 2), cm | 2.7–3.3 | 3.4–3.7 | 3.8–4.1 | >4.2 |
| Base-to-apex length (RVD 3), cm | 7.1–7.9 | 8.0–8.5 | 8.6–9.1 | >9.2 |
| RVOT DIAMETER | | | | |
| Above aortic valve (RVOT 1), cm | 2.5–2.9 | 3.0–3.2 | 3.3–3.5 | >3.6 |
| Above pulmonic valve (RVOT 2), cm | 1.7–2.3 | 2.4–2.7 | 2.8–3.1 | >3.2 |
| PA DIAMETER | | | | |
| Below pulmonic valve (PA 1), cm | 1.5–2.1 | 2.2–2.5 | 2.6–2.9 | >3.0 |
| RV SIZE AND FUNCTION (MEASURED IN A4C) | | | | |
| RV diastolic area, cm2 | 11–28 | 29–32 | 33–37 | >38 |
| RV systolic area, cm2 | 7.5–16 | 17–19 | 20–22 | >23 |
| RV fractional area change, % | 32–60 | 25–31 | 18–24 | <17 |
Atria, left and right
Reference values for the left atrium
| Women | | | | Men | | | |
|---|
| Normal range | Mildly abnormal | Moderately abnormal | Severely abnormal | Normal range | Mildly abnormal | Moderately abnormal | Severely abnormal |
| ATRIAL DIMENSIONS | | | | | | | | |
| LA diameter, cm | 2.7–3.8 | 3.9–4.2 | 4.3–4.6 | >4.7 | 3.0–4.0 | 4.1–4.6 | 4.7–5.2 | >5.2 |
| LA diameter/BSA, cm/m2 | 1.5–2.3 | 2.4–2.6 | 2.7–2.9 | >3.0 | 1.5–2.3 | 2.4–2.6 | 2.7–2.9 | >3.0 |
| RA minor-axis dimension, cm | 2.9–4.5 | 4.6–4.9 | 5.0–5.4 | >5.5 | 2.9–4.5 | 4.6–4.9 | 5.0–5.4 | >5.5 |
| RA minor-axis dimension/BSA, cm/m2 | 1.7–2.5 | 2.6–2.8 | 2.9–3.1 | >3.2 | 1.7–2.5 | 2.6–2.8 | 2.9–3.1 | >3.2 |
| ATRIAL AREA | | | | | | | | |
| LA area, cm2 | <20 | 20–30 | 30–40 | >40 | <20 | 20–30 | 30–40 | >40 |
| ATRIAL VOLUMES | | | | | | | | |
| LA volume, mL | 22–52 | 53–62 | 63–72 | >73 | 18–58 | 59–68 | 69–78 | >79 |
| LA volume/BSA, mL/m2 | 22 ± 6 | 29–33 | 34–39 | >40 | 22 ± 6 | 29–33 | 34–39 | >40 |
BSA, Body surface area; LA, left atrial; RA, right atrial.
Mitral regurgitation (MR)
Primary parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Vena contracta (cm) | < 0.3 | 0.3-0.69 | > 0.69 |
| EROA (cm²) | < 0.20 | 0.20-0.39 | > 0.39 |
| Jet size | < 4cm² or < 20% of atrial size | 4-10 cm² or 20-40% of atrial size | > 10 cm² or > 40% of atrial size |
| Jet orientation | central | variable | excentric |
| Pulmonary vein flow | S-dominant | reduced S-wave | systolic flow reversal, |
Qualitative parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Mitral valve apparatus | normal or mildly abnormal | often abnormal | abnormal, possibly flail |
| CW-profile mitral regurgitation | weak | variable | dense |
| Shape CW-profile mitral regurgitation | parabolic | variable | early peak, triangular |
| Size left atrium | normal | normal or dilated | dilated |
| Size left ventricle | normal | normal or dilated | dilated |
Additional PISA-parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Regurgitation volume (ml/beat) | < 30 | 30-59 | > 59 |
| Regurgitation volume = EROA x TVI | | | |
| Regurgitation fraction (%) | < 30 | 30-49 | > 49 |
Miscellaneous parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| PW-Doppler mitral valve | A dominant | variable | high E values |
References
- Zoghbi, William A.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A.; Kraft, Carol D.; Levine, Robert A. et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 16 (7), pp. 777–802. DOI: 10.1016/S0894-7317(03)00335-3.
- Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A. et al. (2017): Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation. A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. –>Pubmed-Link
Mitral stenosis (MS)
Primary parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Valve area | > 1.5 cm² | 1.5 – 1.0 cm² | < 1.0 cm² |
| Mean gradient | < 5 mmHg | 5-10 mmHg | > 10 mmHg |
Additional parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Pulmonary artery pressure | <30 | 30-50 | >50 |
References
- Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 10 (1), pp. 1–25. DOI: 10.1093/ejechocard/jen303.
- Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 22 (1), 1-23; quiz 101-2. DOI: 10.1016/j.echo.2008.11.029.
- Vahanian, Alec; Alfieri, Ottavio; Andreotti, Felicita; Antunes, Manuel J.; Barón-Esquivias, Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451–2496. DOI: 10.1093/eurheartj/ehs109.
Pulmonary regurgitation (PR)
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Pulmonary valve morphology | normal | normal/abnormal | abnormal |
| Density CW-Doppler | weak, slow deceleration | variable | dense, steep deceleration, early termination of diastolic flow |
| Jet width colour Doppler | small,, < 10 mm length, narrow origin | variable | large, wide origin |
| Ratio pulmonic to aortic flow | normal | variable | significantly increased |
References
- Zoghbi, William A.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A.; Kraft, Carol D.; Levine, Robert A. et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 16 (7), pp. 777–802. DOI: 10.1016/S0894-7317(03)00335-3.
- Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A. et al. (2017): Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation. A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007.
- Lancellotti, Patrizio; Tribouilloy, Christophe; Hagendorff, Andreas; Moura, Luis; Popescu, Bogdan A.; Agricola, Eustachio et al. (2010): European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 11 (3), pp. 223–244. DOI: 10.1093/ejechocard/jeq030.
Pulmonary stenosis (PS)
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Peak velocity (m/s) | < 3 | 3–4 | > 4 |
| Peak gradient (mmHg) | < 36 | 36-64 | > 64 |
References
- Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 10 (1), pp. 1–25. DOI: 10.1093/ejechocard/jen303.
- Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 22 (1), 1-23; quiz 101-2. DOI: 10.1016/j.echo.2008.11.029.
Tricuspid regurgitation (TR)
Primary parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| PISA radius | < 0.6 | 0.6-0.9 | > 0.9 |
| Vena contracta (cm) | not defined | < 0.7 | > 0.7 |
| Liver vein flow | S-dominant | Reduced S-wave | systolic flow reversal, jet reaching liver veins |
Additional quantitative parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Jet size | < 5cm² | 5-10 cm² | > 10 cm² |
| size vena cava inferior | < 2.1 cm and compressible | in between | > 2.1 cm, almost not compressible |
Additional qualitative parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Coaptation defect | mild | moderate | severe |
| Size right ventricle | normal | normal or enlarged | enlarged |
| Size right atrium | normal | normal or enlarged | enlarged |
| CW-profile tricuspid regurgitation | weak | variable | dense |
| Shape CW-profile tricuspid regurgitation | parabolic | variable | early peak, triangular |
References
1. Zoghbi, William A.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A.; Kraft, Carol D.; Levine, Robert A. et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 16 (7), pp. 777–802. DOI: 10.1016/S0894-7317(03)00335-3.
2. Zoghbi, William A.; Adams, David; Bonow, Robert O.; Enriquez-Sarano, Maurice; Foster, Elyse; Grayburn, Paul A. et al. (2017): Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation. A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. –>Pubmed-Link
Tricuspid stenosis (TS)
| Mean pressure gradient | ≥ 5 mmHg |
|---|
| Valve area according to the continuity equation (cm²) | ≤ 1 cm² |
| ZTime-velocity-integral of the tricuspid inflow (cm) | > 60 cm |
| Pressure half time (T ½,ms) | ≥ 190 ms |
| Right atrium | Severly enlarged |
| Vena cava inferior | enlarged |
References
1. Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 10 (1), pp. 1–25. DOI: 10.1093/ejechocard/jen303.
2. Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P. et al. (2009): Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 22 (1), 1-23; quiz 101-2. DOI: 10.1016/j.echo.2008.11.029.
