J wL V m

Tfc. Left Aorta

Atrium

Echocardiography Images

Fig. 11. (A) From the apical windows, the aortic regurgitation jet appears as a diastolic color flow disturbance in the left ventricular outflow tract. Jet length and jet area are influenced by the aortic driving pressure (aorta-to-left ventricular pressure) and are therefore less reliable indicators of disease severity. Measuring jet width from the apical projections is possible, but generally less reliable than parasternal measurements. (B) Continuous-wave (CW) Doppler assessment of flow across the aortic valve in a patient with aortic regurgitation. Many patients have mixed aortic valve disease. Increased transvalvular systolic velocities may represent stenosis. (Please see companion DVD for corresponding video.)

Fig. 11. (A) From the apical windows, the aortic regurgitation jet appears as a diastolic color flow disturbance in the left ventricular outflow tract. Jet length and jet area are influenced by the aortic driving pressure (aorta-to-left ventricular pressure) and are therefore less reliable indicators of disease severity. Measuring jet width from the apical projections is possible, but generally less reliable than parasternal measurements. (B) Continuous-wave (CW) Doppler assessment of flow across the aortic valve in a patient with aortic regurgitation. Many patients have mixed aortic valve disease. Increased transvalvular systolic velocities may represent stenosis. (Please see companion DVD for corresponding video.)

as previously defined. Regurgitant fractions of less than 30% are consistent with mild regurgitation, 30-50% with moderate regurgitation, and more than 50% with severe regurgitation.

The regurgitant orifice area may be calculated as the regurgitant volume multiplied by the VTI of the continuous-wave Doppler jet (Fig. 16). This parameter represents the average size of the defect in the aortic valve during

Moderate Aortic Regurgitation
Fig. 12. Signal intensities in aortic regurgitation severity.
Pressure Half Time Aortic Regurge
Fig. 13. Deceleration rate. The rate of deceleration of the continuous-wave Doppler signal reflects both the degree of regurgitation and the ventricular end-diastolic pressure.
Aortic Regurgitation Pressure Half Time

Fig. 14. Pressure half times (PHT or P 1/2 t). The pressure half time is the time it takes for peak pressure (mmHg) to drop to half its initial value. As the degree of regurgitation increases, the aortic diastolic pressure decreases and the left ventricular end-diastolic pressure increases. This leads to a rapid drop-off in pressure (as well as velocity) across the aortic valve. The more severe the aortic regurgitation, the greater the slope and the shorter the PHT.

Fig. 14. Pressure half times (PHT or P 1/2 t). The pressure half time is the time it takes for peak pressure (mmHg) to drop to half its initial value. As the degree of regurgitation increases, the aortic diastolic pressure decreases and the left ventricular end-diastolic pressure increases. This leads to a rapid drop-off in pressure (as well as velocity) across the aortic valve. The more severe the aortic regurgitation, the greater the slope and the shorter the PHT.

Total Forward Regurgitant Volume = Stroke — Stroke

Volume Volume

LVOT area

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