Chronic aortic regurgitation by Doppler echocardiography
Native valves
Text of this figure
- Chronic aortic regurgitation by Doppler echocardiography
- Yes, mild*
- Yes, severe*
- 2–3
- criteria
- 2–3
- criteria
- ≥4 criteria
- Definitely mild
- (quantitation not needed)
- ≥4 criteria
- Definitely severe
- (may still quantitate)
- 3 specific criteria
- for severe AR
- Chronic aortic regurgitation by Doppler echocardiography
- Does AR meet specific criteria for
- mild or severe AR?
- Specific criteria for mild AR
- • VC width <0.3 cm
- • Central jet width <25% of LVOT
- • Small or no flow convergence
- • Soft or incomplete jet by CW
- • PHT >500 ms
- • Normal LV size
- Specific criteria for severe AR
- • Flail valve
- • VC width >0.6 cm
- • Central jet width ≥65% of LVOT
- • Large flow convergence
- • PHT <200 ms
- • Prominent holodiastolic flow reversal in the
- descending aorta
- • Enlarged LV with normal function
- Intermediate values:
- AR probably moderate
- Perform quantitative methods whenever possible
- to refine assessment
- RVol <30 mL
- RF <30%
- EROA <0.1 cm²
- AR Grade I
- RVol 30–44 mL
- RF 30–39%
- EROA 0.10–0.19 cm²
- AR Grade II
- RVol 45–59 mL
- RF 40–49%
- EROA 0.20–0.29 cm²
- AR Grade III
- RVol ≥60 mL
- RF ≥50%
- EROA ≥0.3 cm²
- AR Grade IV
- Mild AR
- Moderate AR
- Severe AR
- • Poor TTE quality or low confidence in measured Doppler parameters
- • Discordant quantitative and qualitative parameters and/or clinical data
- Indeterminate AR
- Consider further testing:
- TEE or CMR for quantitation
- * Beware of limitations of color flow assessment in eccentric AR jets; volumetric quantitation and integration of other parameters is advised.
- Source: 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 (2017), Figure 25.
- Please read the full document from the ASE.
Redrawn as a flowchart from the published document named in the figure. Read the full document for context and the figures' complete notes.