ReferensvÀrdena nedan Àr hÀmtade frÄn American Society of Echocardiography (ASE) och European Association of Cardiovascular Imaging (EACVI) konsensusdokument. AnvÀnd innehÄllsförteckningen för att hoppa direkt till rÀtt avsnitt.
Aorta, normalvÀrden
| Normalintervall | Normalinterval, justerat |
|---|
| Annulus aortae | 20-31 mm | 12-14 mm/m2 |
| Sinus valsalva | 29-45 mm | 15-20 mm/m2 |
| Sinotubular junction | 22-36 mm | 13-17 mm/m2 |
| Aorta ascendens | 22-36 mm | 13-17 mm/m2 |
| Arcus aortae | 22-36 mm | |
| Aorta descendens | 20-30 mm | |
âJustering innebĂ€r att vĂ€rdet justeras för kroppsyta (BSA, Body Surface Area), som anges i kvadratmeter.
Aorta, standardiserat
Standardiserade vÀrden (medelvÀrde ± SD)
| Age | Annulus aortae, Women | Annulus aortae, Men | Sinus valsalva, Women | Sinus valsalva, Men |
|---|
| <30 | 11.4 ± 1.1 | 11.4 ± 1.2 | 15.5 ± 1.5 | 15.3 ± 1.8 |
| 30â39 | 11.7 ± 1.0 | 11.4 ± 1.1 | 16.5 ± 1.6 | 15.7 ± 1.3* |
| 40â49 | 11.7 ± 1.0 | 11.5 ± 0.9 | 16.8 ± 1.4 | 16.6 ± 1.5 |
| 50â59 | 12.0 ± 0.9 | 11.5 ± 0.9 | 17.9 ± 1.6 | 16.8 ± 1.7* |
| 60â69 | 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 | Aorta ascendens, Women | Aorta ascendens, Men |
|---|
| <30 | 13.5 ± 1.4 | 12.7 ± 2.3 | 15.1 ± 1.6 | 14.3 ± 1.6* |
| 30â39 | 14.3 ± 1.5 | 13.3 ± 1.3 | 16.4 ± 1.8 | 14.5 ± 1.4* |
| 40â49 | 14.6 ± 1.2 | 14.1 ± 1.5* | 16.4 ± 1.4 | 15.5 ± 1.5* |
| 50â59 | 15.7 ± 1.3 | 14.1 ± 1.5 | 18.0 ± 1.4 | 16.2 ± 1.6* |
| 60â69 | 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 | Arcus aortae, Women | Arcus aortae, Men |
|---|
| <30 | 10.7 ± 1.0 | 10.1 ± 1.3* |
| 30â39 | 11.6 ± 1.6 | 10.8 ± 1.3* |
| 40â49 | 11.5 ± 1.2 | 11.3 ± 1.3 |
| 50â59 | 12.7 ± 1.1 | 11.3 ± 1.2* |
| 60â69 | 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 |
Aortainsufficiens (AI)
Primary parameters
| Mild regurgitation | Moderate regurgitation | Severe regurgitation |
|---|
| Vena contracta (cm) | < 0,3 | 0,3-0,6 | > 0,6 |
| PHT (pressure half time) â CW doppler | > 500 | 200-500 | < 200 |
| Diastolic flow reversal â 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 (cmÂČ) | < 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) {{ Flödeshastighet = CSA*v = 6.28*r2*v(aliasing)
Referenser
- 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. 777â802. 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. 303â371. DOI: 10.1016/j.echo.2017.01.007.
Aortastenos (AS)
Disease defining parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Valve area (cmÂČ) | > 1,5 | 1,0-1,5 | < 1,0 |
| Normalized valve area (cmÂČ/mÂČ) | >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 |
Referenser
- 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. 1â25. DOI: 10.1093/ejechocard/jen303.
- Vahanian, Alec; Alfieri, Ottavio; Andreotti, Felicita; Antunes, Manuel J.; BarĂłn-Esquivias, Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451â2496. 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. 372â392. DOI: 10.1016/j.echo.2017.02.009.
VÀnster kammare, funktion, systolisk, visuell bedömning
Visuell bedömning av vÀnster kammares segment (systoliskt funktion)
| TYP AV VĂGGRĂRELSE | DEFINITION | WALL MOTION SCORE |
|---|
| Normal | Normal förtjockning (vanligtvis >30% förtjockning frÄn slutdiastole till slutsystole). | 1 |
| Hypokinesi | Minskad förtjockning (vanligtvis 10â30% förtjockning frĂ„n slutdiastole till slutsystole) | 2 |
| Akinesi | Markant reducerad eller ingen förtjockning (<10%) | 3 |
| Dyskinesi | Paradoxal förtunning och/eller utÄtriktad rörelse under systole | 4 |
| Aneurysmatisk | Diastolisk deformering | 5 |
âDenna semikvantitativa gradering av vĂ€nster kammares systoliska funktion rekommenderas av American Society for Echocardiography (J Am Soc Echocardiogr 18:1440-1463, 2005).
VĂ€nster kammare, massa och geometri
ReferensvÀrden för vÀnster kammares massa och geometri
| Kvinnor | | | | MĂ€n | | | |
|---|
| Referens | LĂ€tt abnormal | Moderat abnormal | Uttalat abnormal | Referens | LĂ€tt abnormal | Moderat abnormal | Uttalat abnormal |
| LINJĂR METOD | | | | | | | | |
| LV mass, g | 67â162 | 163â186 | 187â210 | >211 | 88â224 | 225â258 | 259â292 | >293 |
| LV mass/BSA, g/m2 | 43â95 | 96â108 | 109â121 | > 122 | 49â115 | 116â131 | 132â148 | > 149 |
| LV mass/height, g/m | 41â99 | 100â115 | 116â128 | >129 | 52â126 | 127â144 | 145â162 | >163 |
| LV mass/height 2,7 , g/m2,7 | 18â44 | 45â51 | 52â58 | >59 | 20â48 | 49â55 | 56â63 | >64 |
| Relative wall thickness, cm | 0.22â0.42 | 0.43â0.47 | 0.48â0.52 | >0.53 | 0.24â0.42 | 0.43â0.46 | 0.47â0.51 | >0.52 |
| Septal thickness, cm | 0.6â0.9 | 1.0â1.2 | 1.3â1.5 | > 1.6 | 0.6â1.0 | 1.1â1.3 | 1.4â1.6 | > 1.7 |
| Posterior wall thickness, cm | 0.6â0.9 | 1.0â1.2 | 1.3â1.5 | > 1.6 | 0.6â1.0 | 1.1â1.3 | 1.4â1.6 | > 1.7 |
| 2D METOD | | | | | | | | |
| LV mass, g | 66â150 | 151â171 | 172â182 | > 193 | 96â200 | 201â227 | 228â254 | > 255 |
| LV mass/BSA, g/m2 | 44â88 | 89â100 | 101â112 | > 113 | 50â102 | 103â116 | 117â130 | > 131 |
BSA, Body surface area; LV, left ventricular; 2D, 2-dimensional. Fet kursiv stil: rekommenderad och bÀst validerad.
VĂ€nster kammare, storlek
ReferensvÀrden för vÀnster kammares storlek
| Kvinnor | | | | MĂ€n | | | |
|---|
| Normalintervall | LÀtt abnormal | MÄttligt abnormal | Uttalat abnormal | Normalintervall | LÀtt abnormal | MÄttligt abnormal | Uttalat abnormal |
| LV DIMENSIONS | | | | | | | | |
| LV diastolic diameter | 3.9â5.3 | 5.4â5.7 | 5.8â6.1 | >6.2 | 4.2â5.9 | 6.0â6.3 | 6.4â6.8 | >6.9 |
| LV diastolic diameter/BSA, cm/m 2 | 2.4â3.2 | 3.3â3.4 | 3.5â3.7 | >3.8 | 2.2â3.1 | 3.2â3.4 | 3.5â3.6 | >3.7 |
| LV diastolic diameter/height, cm/m | 2.5â3.2 | 3.3â3.4 | 3.5â3.6 | >3.7 | 2.4â3.3 | 3.4â3.5 | 3.6â3.7 | >3.8 |
| LV VOLUME | | | | | | | | |
| LV diastolic volume, mL | 56â104 | 105â117 | 118â130 | >131 | 67â155 | 156â178 | 179â201 | >201 |
| LV diastolic volume/BSA, mL/m 2 | 35â75 | 76â86 | 87â96 | > 97 | 35â75 | 76â86 | 87â96 | > 97 |
| LV systolic volume, mL | 19â49 | 50â59 | 60â69 | >70 | 22â58 | 59â70 | 71â82 | >83 |
| LV systolic volume/BSA, mL/m 2 | 12â30 | 31â36 | 37â42 | > 43 | 12â30 | 31â36 | 37â42 | > 43 |
BSA, body surface area; LV, left ventricular. Fet kursiv stil: rekommenderad och bÀst validerad.
VĂ€nster kammare, funktion
ReferensvÀrden för vÀnsterkammarfunktion
| Kvinnor | | | | MĂ€n | | | |
|---|
| Normal | LÀtt abnormal | MÄttligt abnormal | Uttalat abnormal | Normal | LÀtt abnormal | MÄttligt abnormal | Uttalat abnormal |
| LINJĂR METOD | | | | | | | | |
| Endocardial fractional shortening, % | 27â45 | 22â26 | 17â21 | <16 | 25â43 | 20â24 | 15â19 | <14 |
| Midwall fractional shortening, % | 15â23 | 13â14 | 11â12 | <10 | 14â22 | 12â13 | 10â11 | <10 |
| 2D METOD | | | | | | | | |
| Ejection fraction, % | >55 | 45â54 | 30â44 | <30 | >55 | 45â54 | 30â44 | <30 |
2D, Two-dimensional. Fet kursiv: rekommenderad och bÀst validerad.
Ny klassificering av ejektionsfraktion
| 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 |
Referenser
- 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. 233â270. 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 Echocardiographyâs 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. 1440â1463. DOI: 10.1016/j.echo.2005.10.005. â>Pubmed-Link
VĂ€nster kammare, funktion, diastolisk
| Criteria | Normal ung | Normal vuxen | Abnormal relaxation (grad 1 dysfunktion) | Pseudonormal (grad 2 dysfunktion) | Reversibel restriktiv fyllnad (grad 3 dysfunktion) | Irreversibel restriktiv fyllnad (grad 4 dysfunktion) |
|---|
| E/A-ratio | 1â2 | 1â2 | <1 | 1â1.5 (reverserar med Valsalva-manöver) | >1.5 | 1.5â2.0 (reverserar inte med Valsalva-manöver) |
| Deceleration time (DT), ms | <240 | 150â240 | â„240 | 150â200 | <150 | <150 |
| IVRT (ms) | 70â90 | 70â90 | >90 | <90 | <70 | <70 |
| S/D-ratio | <1 | â„1 | â„1 | <1 | <1 | <1 |
| ARdur â Adur (ms) | â„30 | â€0 | â€0 eller â„30 | â„30 | â„30 | â„30 |
| AR speed (cm/s) | <35 | <35 | <35 | â„35 | â„35 | â„35 |
| eâ speed (cm/s) | >10 | >8 | <8 | <8 | <8 | <8 |
För att erhĂ„lla âARdurâAdurâ subtraheras Adur frĂ„n ARdur.AR hastighet Ă€r flödeshastigheten pĂ„ den negativa vĂ„gen som registreras vid lungvensdoppler (AR = atrial regurgitation).
Höger kammare och lungartÀr
| Normalintervall | LÀtt abnormal | MÄttligt abnormal | Uttalat abnormal |
|---|
| RV DIMENSIONS | | | | |
| Basal RV diameter (RVD 1), cm | 2.0â2.8 | 2.9â3.3 | 3.4â3.8 | >3.9 |
| Mid RV diameter (RVD 2), cm | 2.7â3.3 | 3.4â3.7 | 3.8â4.1 | >4.2 |
| Base-to-apex length (RVD 3), cm | 7.1â7.9 | 8.0â8.5 | 8.6â9.1 | >9.2 |
| RVOT DIAMETER | | | | |
| Above aortic valve (RVOT 1), cm | 2.5â2.9 | 3.0â3.2 | 3.3â3.5 | >3.6 |
| Above pulmonic valve (RVOT 2), cm | 1.7â2.3 | 2.4â2.7 | 2.8â3.1 | >3.2 |
| PA DIAMETER | | | | |
| Below pulmonic valve (PA 1), cm | 1.5â2.1 | 2.2â2.5 | 2.6â2.9 | >3.0 |
| RV SIZE AND FUNCTION (MEASURED IN A4C) | | | | |
| RV diastolic area, cm2 | 11â28 | 29â32 | 33â37 | >38 |
| RV systolic area, cm2 | 7.5â16 | 17â19 | 20â22 | >23 |
| RV fractional area change, % | 32â60 | 25â31 | 18â24 | <17 |
ReferensvÀrden för vÀnster förmak
| Kvinnor | | | | MĂ€n | | | |
|---|
| Normalintervall | LÀtt abnormal | MÄttligt abnormal | Uttalat abnormal | Normalintervall | LÀtt abnormal | MÄttligt abnormal | Uttalat abnormal |
| ATRIAL DIMENSIONS | | | | | | | | |
| LA diameter, cm | 2.7â3.8 | 3.9â4.2 | 4.3â4.6 | >4.7 | 3.0â4.0 | 4.1â4.6 | 4.7â5.2 | >5.2 |
| LA diameter/BSA, cm/m2 | 1.5â2.3 | 2.4â2.6 | 2.7â2.9 | >3.0 | 1.5â2.3 | 2.4â2.6 | 2.7â2.9 | >3.0 |
| RA minor-axis dimension, cm | 2.9â4.5 | 4.6â4.9 | 5.0â5.4 | >5.5 | 2.9â4.5 | 4.6â4.9 | 5.0â5.4 | >5.5 |
| RA minor-axis dimension/BSA, cm/m2 | 1.7â2.5 | 2.6â2.8 | 2.9â3.1 | >3.2 | 1.7â2.5 | 2.6â2.8 | 2.9â3.1 | >3.2 |
| ATRIAL AREA | | | | | | | | |
| LA area, cm2 | <20 | 20â30 | 30â40 | >40 | <20 | 20â30 | 30â40 | >40 |
| ATRIAL VOLUMES | | | | | | | | |
| LA volume, mL | 22â52 | 53â62 | 63â72 | >73 | 18â58 | 59â68 | 69â78 | >79 |
| LA volume/BSA, mL/m2 | 22 ± 6 | 29â33 | 34â39 | >40 | 22 ± 6 | 29â33 | 34â39 | >40 |
âBSA, Body surface area; LA, left atrial; RA, right atrial.
Mitralisinsufficiens (MI)
Primary parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Vena contracta (cm) | < 0,3 | 0,3-0,69 | > 0,69 |
| EROA (cmÂČ) | < 0,20 | 0,20-0,39 | > 0,39 |
| Jet size | < 4cmÂČ or < 20% of atrial size | 4-10 cmÂČ or 20-40% of atrial size | > 10 cmÂČ 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 |
Referenser
- 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. 777â802. 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. 303â371. DOI: 10.1016/j.echo.2017.01.007. â>Pubmed-Linkâ
Mitralisstenos (MS)
Primary parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Valve area | > 1,5 cmÂČ | 1,5 â 1,0 cmÂČ | < 1,0 cmÂČ |
| Mean gradient | < 5 mmHg | 5-10 mmHg | > 10 mmHg |
Additional parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Pulmonary artery pressure | <30 | 30-50 | >50 |
Referenser
- 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. 1â25. 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.; BarĂłn-Esquivias, Gonzalo; Baumgartner, Helmut et al. (2012): Guidelines on the management of valvular heart disease (version 2012). In European heart journal 33 (19), pp. 2451â2496. DOI: 10.1093/eurheartj/ehs109.
Pulmonalisinsufficiens (PI)
| 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 |
Referenser
- 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. 777â802. 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. 303â371. 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. 223â244. DOI: 10.1093/ejechocard/jeq030.
Pulmonalisstenos (PS)
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Peak velocity (m/s) | < 3 | 3â4 | > 4 |
| Peak gradient (mmHg) | < 36 | 36-64 | > 64 |
Referenser
- 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. 1â25. 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.
Trikuspidalisinsufficiens (TI)
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 | < 5cmÂČ | 5-10 cmÂČ | > 10 cmÂČ |
| 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 |
Referenser
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. 777â802. 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. 303â371. DOI: 10.1016/j.echo.2017.01.007. â>Pubmed-Link
Trikuspidalisstenos (TS)
| Mean pressure gradient | â„ 5 mmHg |
|---|
| Valve area according to the continuity equation (cmÂČ) | †1 cmÂČ |
| ZTime-velocity-integral of the tricuspid inflow (cm) | > 60 cm |
| Pressure half time (T œ,ms) | ℠190 ms |
| Right atrium | Severly enlarged |
| Vena cava inferior | enlarged |
Referenser
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. 1â25. 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.