Die nachstehenden Referenzwerte stammen aus den Konsensusdokumenten der American Society of Echocardiography (ASE) und der European Association of Cardiovascular Imaging (EACVI). Über das Inhaltsverzeichnis lässt sich direkt zum gewünschten Abschnitt springen. Die Tabellen geben die englischen Originalbezeichnungen der Leitliniendokumente wieder.
Aorta, Normwerte
| Normbereich | Normbereich, indexiert |
|---|
| 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 | |
Die Indexierung bedeutet, dass der Wert auf die Körperoberfläche (BSA, Body Surface Area) in Quadratmetern bezogen wird.
Aorta, standardisierte Werte
Standardisierte Werte (Mittelwert ± 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 |
| 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 |
| 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* |
| 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 |
| Age | Arcus aortae, Women | Arcus aortae, 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 |
Aortenklappeninsuffizienz (AI)
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 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 (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) {{ Flussgeschwindigkeit = CSA*v = 6.28*r2*v(aliasing)
Literatur
- 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.
- 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.
Aortenklappenstenose (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 / aotric valve) | | > 0,5 | 0,5-0,25 | < 0,25 |
Literatur
- 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. 1–25. DOI: 10.1093/ejechocard/jen303.
- 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.
- 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.
Linker Ventrikel, systolische Funktion, visuelle Beurteilung
Visuelle Beurteilung der Segmente des linken Ventrikels (systolische Funktion)
| ART DER WANDBEWEGUNG | DEFINITION | WALL MOTION SCORE |
|---|
| Normal | Normale Verdickung (üblicherweise >30 % Verdickung von der Enddiastole zur Endsystole). | 1 |
| Hypokinesie | Verminderte Verdickung (üblicherweise 10–30 % Verdickung von der Enddiastole zur Endsystole) | 2 |
| Akinesie | Deutlich verminderte oder fehlende Verdickung (<10 %) | 3 |
| Dyskinesie | Paradoxe Ausdünnung und/oder nach außen gerichtete Bewegung während der Systole | 4 |
| Aneurysmatisch | Diastolische Deformierung | 5 |
Diese semiquantitative Graduierung der systolischen Funktion des linken Ventrikels wird von der American Society for Echocardiography empfohlen (J Am Soc Echocardiogr 18:1440-1463, 2005).
Linker Ventrikel, Masse und Geometrie
Referenzwerte für Masse und Geometrie des linken Ventrikels
| Frauen | | | | Männer | | | |
|---|
| Referenz | Leicht abnorm | Mäßig abnorm | Deutlich abnorm | Referenz | Leicht abnorm | Mäßig abnorm | Deutlich abnorm |
| LINEARE METHODE | | | | | | | | |
| LV mass, g | 67–162 | 163–186 | 187–210 | >211 | 88–224 | 225–258 | 259–292 | >293 |
| LV mass/BSA, g/m2 | 43–95 | 96–108 | 109–121 | > 122 | 49–115 | 116–131 | 132–148 | > 149 |
| LV mass/height, g/m | 41–99 | 100–115 | 116–128 | >129 | 52–126 | 127–144 | 145–162 | >163 |
| LV mass/height 2,7 , g/m2,7 | 18–44 | 45–51 | 52–58 | >59 | 20–48 | 49–55 | 56–63 | >64 |
| Relative wall thickness, cm | 0.22–0.42 | 0.43–0.47 | 0.48–0.52 | >0.53 | 0.24–0.42 | 0.43–0.46 | 0.47–0.51 | >0.52 |
| Septal thickness, cm | 0.6–0.9 | 1.0–1.2 | 1.3–1.5 | > 1.6 | 0.6–1.0 | 1.1–1.3 | 1.4–1.6 | > 1.7 |
| Posterior wall thickness, cm | 0.6–0.9 | 1.0–1.2 | 1.3–1.5 | > 1.6 | 0.6–1.0 | 1.1–1.3 | 1.4–1.6 | > 1.7 |
| 2D-METHODE | | | | | | | | |
| LV mass, g | 66–150 | 151–171 | 172–182 | > 193 | 96–200 | 201–227 | 228–254 | > 255 |
| LV mass/BSA, g/m2 | 44–88 | 89–100 | 101–112 | > 113 | 50–102 | 103–116 | 117–130 | > 131 |
BSA, Body surface area; LV, left ventricular; 2D, 2-dimensional. Fett kursiv: empfohlen und am besten validiert.
Linker Ventrikel, Größe
Referenzwerte für die Größe des linken Ventrikels
| Frauen | | | | Männer | | | |
|---|
| Normbereich | Leicht abnorm | Mäßig abnorm | Deutlich abnorm | Normbereich | Leicht abnorm | Mäßig abnorm | Deutlich abnorm |
| LV DIMENSIONS | | | | | | | | |
| LV diastolic diameter | 3.9–5.3 | 5.4–5.7 | 5.8–6.1 | >6.2 | 4.2–5.9 | 6.0–6.3 | 6.4–6.8 | >6.9 |
| LV diastolic diameter/BSA, cm/m 2 | 2.4–3.2 | 3.3–3.4 | 3.5–3.7 | >3.8 | 2.2–3.1 | 3.2–3.4 | 3.5–3.6 | >3.7 |
| LV diastolic diameter/height, cm/m | 2.5–3.2 | 3.3–3.4 | 3.5–3.6 | >3.7 | 2.4–3.3 | 3.4–3.5 | 3.6–3.7 | >3.8 |
| LV VOLUME | | | | | | | | |
| LV diastolic volume, mL | 56–104 | 105–117 | 118–130 | >131 | 67–155 | 156–178 | 179–201 | >201 |
| LV diastolic volume/BSA, mL/m 2 | 35–75 | 76–86 | 87–96 | > 97 | 35–75 | 76–86 | 87–96 | > 97 |
| LV systolic volume, mL | 19–49 | 50–59 | 60–69 | >70 | 22–58 | 59–70 | 71–82 | >83 |
| LV systolic volume/BSA, mL/m 2 | 12–30 | 31–36 | 37–42 | > 43 | 12–30 | 31–36 | 37–42 | > 43 |
BSA, body surface area; LV, left ventricular. Fett kursiv: empfohlen und am besten validiert.
Linker Ventrikel, Funktion
Referenzwerte für die linksventrikuläre Funktion
| Frauen | | | | Männer | | | |
|---|
| Normal | Leicht abnorm | Mäßig abnorm | Deutlich abnorm | Normal | Leicht abnorm | Mäßig abnorm | Deutlich abnorm |
| LINEARE METHODE | | | | | | | | |
| Endocardial fractional shortening, % | 27–45 | 22–26 | 17–21 | <16 | 25–43 | 20–24 | 15–19 | <14 |
| Midwall fractional shortening, % | 15–23 | 13–14 | 11–12 | <10 | 14–22 | 12–13 | 10–11 | <10 |
| 2D-METHODE | | | | | | | | |
| Ejection fraction, % | >55 | 45–54 | 30–44 | <30 | >55 | 45–54 | 30–44 | <30 |
2D, Two-dimensional. Fett kursiv: empfohlen und am besten validiert.
Neue Klassifikation der 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 |
Literatur
- 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. 233–270. 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 Echocardiography’s 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. 1440–1463. DOI: 10.1016/j.echo.2005.10.005. –>Pubmed-Link
Linker Ventrikel, diastolische Funktion
| Criteria | Normal, jung | Normal, erwachsen | Relaxationsstörung (Dysfunktion Grad 1) | Pseudonormal (Dysfunktion Grad 2) | Reversible restriktive Füllung (Dysfunktion Grad 3) | Irreversible restriktive Füllung (Dysfunktion Grad 4) |
|---|
| E/A-ratio | 1–2 | 1–2 | <1 | 1–1.5 (reversibel im Valsalva-Manöver) | >1.5 | 1.5–2.0 (nicht reversibel im Valsalva-Manöver) |
| Deceleration time (DT), ms | <240 | 150–240 | ≥240 | 150–200 | <150 | <150 |
| IVRT (ms) | 70–90 | 70–90 | >90 | <90 | <70 | <70 |
| S/D-ratio | <1 | ≥1 | ≥1 | <1 | <1 | <1 |
| ARdur – Adur (ms) | ≥30 | ≤0 | ≤0 oder ≥30 | ≥30 | ≥30 | ≥30 |
| AR speed (cm/s) | <35 | <35 | <35 | ≥35 | ≥35 | ≥35 |
| e’ speed (cm/s) | >10 | >8 | <8 | <8 | <8 | <8 |
Zur Bestimmung von „ARdur–Adur" wird Adur von ARdur subtrahiert. Die AR-Geschwindigkeit ist die Flussgeschwindigkeit der negativen Welle, die im Pulmonalvenen-Doppler registriert wird (AR = atrial regurgitation).
Rechter Ventrikel und Pulmonalarterie
| Normbereich | Leicht abnorm | Mäßig abnorm | Deutlich abnorm |
|---|
| 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 |
Vorhöfe, links und rechts
Referenzwerte für den linken Vorhof
| Frauen | | | | Männer | | | |
|---|
| Normbereich | Leicht abnorm | Mäßig abnorm | Deutlich abnorm | Normbereich | Leicht abnorm | Mäßig abnorm | Deutlich abnorm |
| ATRIAL DIMENSIONS | | | | | | | | |
| LA diameter, cm | 2.7–3.8 | 3.9–4.2 | 4.3–4.6 | >4.7 | 3.0–4.0 | 4.1–4.6 | 4.7–5.2 | >5.2 |
| LA diameter/BSA, cm/m2 | 1.5–2.3 | 2.4–2.6 | 2.7–2.9 | >3.0 | 1.5–2.3 | 2.4–2.6 | 2.7–2.9 | >3.0 |
| RA minor-axis dimension, cm | 2.9–4.5 | 4.6–4.9 | 5.0–5.4 | >5.5 | 2.9–4.5 | 4.6–4.9 | 5.0–5.4 | >5.5 |
| RA minor-axis dimension/BSA, cm/m2 | 1.7–2.5 | 2.6–2.8 | 2.9–3.1 | >3.2 | 1.7–2.5 | 2.6–2.8 | 2.9–3.1 | >3.2 |
| ATRIAL AREA | | | | | | | | |
| LA area, cm2 | <20 | 20–30 | 30–40 | >40 | <20 | 20–30 | 30–40 | >40 |
| ATRIAL VOLUMES | | | | | | | | |
| LA volume, mL | 22–52 | 53–62 | 63–72 | >73 | 18–58 | 59–68 | 69–78 | >79 |
| LA volume/BSA, mL/m2 | 22 ± 6 | 29–33 | 34–39 | >40 | 22 ± 6 | 29–33 | 34–39 | >40 |
BSA, Body surface area; LA, left atrial; RA, right atrial.
Mitralklappeninsuffizienz (MI)
Primary parameters
| Mild regurgiation | Moderate regurgitation | Severe regurgitation |
|---|
| Vena contracta (cm) | < 0,3 | 0,3-0,69 | > 0,69 |
| EROA (cm²) | < 0,20 | 0,20-0,39 | > 0,39 |
| Jet size | < 4cm² or < 20% of atrial size | 4-10 cm² or 20-40% of atrial size | > 10 cm² 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 |
Literatur
- 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.
- 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
Mitralklappenstenose (MS)
Primary parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Valve area | > 1,5 cm² | 1,5 – 1,0 cm² | < 1,0 cm² |
| Mean gradient | < 5 mmHg | 5-10 mmHg | > 10 mmHg |
Additional parameters
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Pulmonary artery pressure | <30 | 30-50 | >50 |
Literatur
- 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.
- 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.; 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.
Pulmonalklappeninsuffizienz (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 |
Literatur
- 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.
- 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.
- 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.
Pulmonalklappenstenose (PS)
| Mild stenosis | Moderate stenosis | Severe stenosis |
|---|
| Peak velocity (m/s) | < 3 | 3–4 | > 4 |
| Peak gradient (mmHg) | < 36 | 36-64 | > 64 |
Literatur
- 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.
- 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.
Trikuspidalklappeninsuffizienz (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 | < 5cm² | 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 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 |
Literatur
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
Trikuspidalklappenstenose (TS)
| 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 | Severly enlarged |
| Vena cava inferior | enlarged |
Literatur
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.
Autoren
Aktualisiert 19. August 2026
