Tuesday 22 January 2013

Makna Nilai Hasil Pengukuran Katup-Katup Jantung dengan Ekokardiografi (Guidelines)

1.    Mitral stenosis

Normal
Mild
Moderate
Severe
Pressure half time (ms)
40–70    
71–139 
140–219
> 219
Mean pressure drop (mmHg)

< 5.0
5–10 
> 10
Valve area (cm 2 )
4.0–6.0   
1.6–2.0
1.0–1.5 
< 1.0

2.    Mitral regurgitation

Mild
Moderate
Severe
Jet area (cm 2 )
< 4

> 10
Jet area / LA (%)
< 20%      

> 40%
Vena contracta (cm)
< 0.3

≥ 0.7
PISA radius (Nyquist 40cm/s)
< 0.4    

> 1.0
Regurgitant volume (mL)
< 30
31–59
≥ 60
Regurgitant Fraction (%)
< 30
31–49
≥ 50
Regurgitant orifice area (cm 2 )
< 0.20 
0.21–0.39 
≥ 0.40

3.    Tricuspid  stenosis

Normal
Severe
Mean pressure drop (mmHg)          
-   
≥ 5
Valve area (cm 2 )
> 7.0
< 1.0

4.    Tricuspid regurgitation

Mild
Moderate
Severe
Jet area (cm 2 )
< 5
5–10
> 10
VC width (cm)
  Not defined  
< 0.7 
> 0.7
PISA radius (cm)
< 0.5 
0.6-0.9 
> 0.9
CW jet density/contour
  Soft/
parabolic
  Dense/
variable 
Dense /
triangular early peaking
RA/RV/IVC size
Normal
Normal/dilated    
Usually dilated
Hepatic vein flow
Systolic
dominance
Systolic
blunting
Systolic
reversal

5.    Aortic stenosis

Normal
Mild
Moderate
Severe
Peak velocity (m/s)
< 1.7
1.7–2.9 
3.0–4.0 
> 4.0
Peak pressure drop (mmHg)
-
< 36 
36–64 
> 64
Mean pressure drop (mmHg)
-
< 25 
25–40 
> 40
Valve area (cm 2 )
> 2.0 
1.5–2.0 
  1.0–1.4 
< 1.0

6.    Aortic regurgitation

Mild
Moderate
Severe
Vena Contracta width (cm)
< 0.3     

> 0.6
Jet width/LVOT diam. (%)
< 25   

≥ 65
Regurgitant Volume (ml/beat)
< 30 
31–59
≥ 60
Regurgitant Fraction (%)
< 30 
31– 49
≥ 50
Regurgitant Orifice area  (cm 2 )
< 0.10 
0.11–0.29 
≥ 0.30
VTI diastolic flow reversal (upper DAo) (cm)
-

15
Pressure Half Time (ms)
  > 500   

< 250

7.    Aortic dimensions
echocardiography Aortic dimensions

8.    Pulmonary stenosis

Mild
Moderate
Severe
Peak pressure drop (mmHg)
< 40   
40–75
> 75

9.    Pulmonary regurgitation

Mild
Moderate
Severe
Jet size (CFM) (cm)
Narrow, < 1.0            
Intermediate
Wide, large
Regurgitant Fraction (%)
  < 40                          
40–60   
≥ 65
CW jet density/deceleration rate
Soft/slow     
Dense/variable     
Dense/steep
RVOTVTI / LVOTVTI
↑↑
↑↑
↑↑↑

Dikutip dari: Echocardiography: Guidelines for Valve Quantification
(British Society of Echocardiography)