Tricuspid valve regurgitation
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 valve stenosis
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 | Pressure half time (T ½, ms) |
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.
Pulmonary valve
Pulmonary valve regurgitation
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
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.
3. 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 valve stenosis
Mild stenosis | Moderate stenosis | Severe stenosis | |
Peak velocity (m/s) | < 3 | 43528 | > 4 |
Peak gradient (mmHg) | < 36 | 36-64 | > 64 |
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.