Mitral valve

Mitral valve regurgitation

Primary parameters

 Mild regurgiationModerate regurgitationSevere regurgitation
Vena contracta (cm)< 0,30,3-0,69> 0,69
EROA (cm²)< 0,200,20-0,39> 0,39
Jet size< 4cm² or < 20% of atrial size4-10 cm² or 20-40% of atrial size> 10 cm² or > 40% of atrial size
Jet orientationcentralvariableexcentric
Pulmonary vein flowS-dominantreduced S-wavesystolic flow reversal,

Qualitative parameters

 Mild regurgiationModerate regurgitationSevere regurgitation
Mitral valve apparatusnormal or mildly abnormaloften abnormalabnormal, possibly flail
CW-profile mitral regurgitationweakvariabledense
Shape CW-profile mitral regurgitationparabolicvariableearly peak, triangular
Size left atriumnormalnormal or dilateddilated
Size left ventriclenormalnormal or dilateddilated

Additional PISA-parameters

 Mild regurgiationModerate regurgitationSevere regurgitation
Regurgitation volume (ml/beat)< 3030-59> 59
Regurgitation volume = EROA x TVI   
Regurgitation fraction (%)< 3030-49> 49

Miscellaneous parameters

 Mild regurgiationModerate regurgitationSevere regurgitation
PW-Doppler mitral valveA dominantvariablehigh E values

​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.

Mitral valve stenosis

Primary parameters

 Mild stenosisModerate stenosisSevere stenosis
Valve area> 1,5 cm²1,5 – 1,0 cm²< 1,0 cm²
Mean gradient< 5 mmHg5-10 mmHg> 10 mmHg

Additional parameters

 Mild stenosisModerate stenosisSevere stenosis
Pulmonary artery pressure<3030-50>50

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.

3. 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.

Updated on 2025-01-18