Parameters of Pulmonary stenosis on Echocardiography

  • Pulmonary Regurgitation

    Mild
    Moderate
    Severe
    Pulmonic valve Normal Normal or abnormal Abnormal and may not be visible
    Right ventricle (Size) Normal1

    (RVD1basal <41mm)

    		 Normal or dilated Dilated2

    (RVD1basal >41mm)
    RegJetlength

    Regurgitant jet length
    (Nyquist limit 50-70cm/s)

    		 Thin with a narrow origin

    (usually <10 mm in length)

    		 Intermediate Broad origin; variable depth of penetration
    RatioRegJet/PV

    Ratio regurgitant jet width / pulmonary valve annulus

    		 >70%3
    RegJetdensity

    Regurgitant jet density
    (CW doppler)

    		 Soft Dense Dense; early termination of diastolic flow
    DTRegJet

    Deceleration time of pulmonary regurgitant jet

    		 Short4

    (<260ms)
    PHTRegJet

    Pressure half time of pulmonary regurgitant jet

    		 <100ms5
    PR index6

    Pulmonary regurgitation index

    		 <0,77 <0,77
    PAreversal flow

    Reversal flow in the branch pulmonary artery

    		 Yes
    PV VTI / LVOT VTI7

    Pulmonic systolic VTI compered to LVOT VTI

    		 Slightly increased Intermediate Greatly increased
    RF8

    Regurgitant fraction of pulmonary valve

    		 <20% 20-40% >40%

    (1) Unless there are other reasons for RV enlargement. (2) Exception: acute PR. (3) Identifies a CMR-derived PR fraction >40%. (4) Steep deceleration is not specific for severe PR. (5) Not reliable in the presence of high RV end diastolic pressure. (6) Defined as the duration of the PR signal divided by the total duration of diastole, with this cutoff identifying a CMR-derived PR fraction > 25%. (7) Cut off values for regurgitant volume and fraction are not well validated. (8) RF data primarily derived from CMR with limited application with echocardiography.

    ASE Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation (2017)