Mitral valve regurgitation
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
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 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
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.