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Aortic dimensions using 2D echocardiography
| Normal interval | Normal interval, adjusted | |
| Aortic annulus | 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 |
| Ascending aorta | 22-36 mm | 13-17 mm/m² |
| Aortic arch | 22-36 mm | |
| Descending aorta | 20-30 mm |
Adjustment refers to adjusting for body surface area (BSA).
Standardized values for aorta (mean ± SD)
| Aortic annulus | Sinus valsalva | |||
| Age | Women | Men | Women | Men |
| <30 | 11.4 ± 1.1 | 11.4 ± 1.2 | 15.5 ± 1.5 | 15.3 ± 1.8 |
| 30–39 | 11.7 ± 1.0 | 11.4 ± 1.1 | 16.5 ± 1.6 | 15.7 ± 1.3* |
| 40–49 | 11.7 ± 1.0 | 11.5 ± 0.9 | 16.8 ± 1.4 | 16.6 ± 1.5 |
| 50–59 | 12.0 ± 0.9 | 11.5 ± 0.9 | 17.9 ± 1.6 | 16.8 ± 1.7* |
| 60–69 | 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 |
| Sinotubular junction | Ascending aorta | |||
| Age | Women | Men | Women | Men |
| <30 | 13.5 ± 1.4 | 12.7 ± 2.3 | 15.1 ± 1.6 | 14.3 ± 1.6* |
| 30–39 | 14.3 ± 1.5 | 13.3 ± 1.3 | 16.4 ± 1.8 | 14.5 ± 1.4* |
| 40–49 | 14.6 ± 1.2 | 14.1 ± 1.5* | 16.4 ± 1.4 | 15.5 ± 1.5* |
| 50–59 | 15.7 ± 1.3 | 14.1 ± 1.5 | 18.0 ± 1.4 | 16.2 ± 1.6* |
| 60–69 | 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 |
| Aortic arch | ||
| Age | Women | Men |
| <30 | 10.7 ± 1.0 | 10.1 ± 1.3* |
| 30–39 | 11.6 ± 1.6 | 10.8 ± 1.3* |
| 40–49 | 11.5 ± 1.2 | 11.3 ± 1.3 |
| 50–59 | 12.7 ± 1.1 | 11.3 ± 1.2* |
| 60–69 | 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 |
Aortic regurgitation (AR)
Primary parameters
| Mild regurgitation | Moderate regurgitation | Severe regurgitation | |
| Vena contracta (cm) | < 0,3 | 0,3-0,6 | > 0,6 |
| PHT (pressure half time) – CW Doppler | > 500 | 200-500 | < 200 |
| Diastolic flow reversal – PW Doppler aorta descendens | if present, early diastolic | early diastolic | holodiastolic |
Quantification of regurgitant 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 eccentric |
| 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 (cm²) | < 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) {{ flow velocity = CSA*v = 6.28*r²*v(aliasing)
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.
Aortic stenosis (AS)
Disease defining parameters
| Mild stenosis | Moderate stenosis | Severe stenosis | |
| Valve area (cm²) | > 1,5 | 1,0-1,5 | < 1,0 |
| Normalized valve area (cm²/m²) | > 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 / aortic valve) | > 0,5 | 0,5-0,25 | < 0,25 |
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 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.
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 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.
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.
4. 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. 372–392. DOI : 10.1016/j.echo.2017.02.009.