Right ventricle and pulmonary artery
| Normal interval | Mildly abnormal | Moderately abnormal | Severely abnormal | |
| RV DIMENSIONS | ||||
| Basal RV diameter (RVD 1), cm | 2.0–2.8 | 2.9–3.3 | 3.4–3.8 | >3.9 |
| Mid RV diameter (RVD 2), cm | 2.7–3.3 | 3.4–3.7 | 3.8–4.1 | >4.2 |
| Base-to-apex length (RVD 3), cm | 7.1–7.9 | 8.0–8.5 | 8.6–9.1 | >9.2 |
| RVOT DIAMETER | ||||
| Above aortic valve (RVOT 1), cm | 2.5–2.9 | 3.0–3.2 | 3.3–3.5 | >3.6 |
| Above pulmonic valve (RVOT 2), cm | 1.7–2.3 | 2.4–2.7 | 2.8–3.1 | >3.2 |
| PA DIAMETER | ||||
| Below pulmonic valve (PA 1), cm | 1.5–2.1 | 2.2–2.5 | 2.6–2.9 | >3.0 |
| RV SIZE AND FUNCTION (MEASURED IN A4C) | ||||
| RV diastolic area, cm² | 11–28 | 29–32 | 33–37 | >38 |
| RV systolic area, cm² | 7.5–16 | 17–19 | 20–22 | >23 |
| RV fractional area change, % | 32–60 | 25–31 | 18–24 | <17 |
Tricuspid valve
Tricuspid valve regurgitation
Primary parameters
| Mild regurgitation | 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 regurgitation | Moderate regurgitation | Severe regurgitation | |
| Jet size | < 5 cm² | 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 regurgitation | 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 | Severely enlarged |
| 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 regurgitation | 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 | 3-4 | > 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) : Évaluation échocardiographique de la sténose valvulaire : recommandations de l’EAE/ASE pour la pratique clinique. 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.