|
Mitral Stenosis |
| Parameter |
Mild |
Moderate |
Severe |
| Planimetered orifice
area (cm2) |
>1.5 |
1.0-1.5 |
<1.0 |
| Pressure half time
(ms) |
<150 |
150-200 |
>200 |
| Mean gradient (mmHg) |
<5 |
5-10 |
>10 |
| PA systolic pressure
(mmHg) |
25 |
25-35 |
>35 |
| Note values in
Catherine Otto's Book Clinical Echocardiography are
significantly higher with severe MS defined as a mean gradient
of >15, PA pressure >60 but valve area still <1cm2 |
|
Aortic Stenosis |
| Parameter |
Mild |
Moderate |
Severe |
| Aortic Vmax (m/s) |
2.0-3.0 |
3.0-4.5 |
>4.5 |
| Peak gradient (mmHg) |
<40 |
40-80 |
>80 |
| Mean gradient (mmHg) |
<20 |
20-50 |
>50 |
| Valve area (cm2) |
>1.0 |
0.6-1.0 |
<0.6 |
| Note these ranges
are different from those published by the AHA/ACC: |
| Aortic Vmax (m/s) |
<3.0 |
3.0-4.0 |
>4.0 |
| Peak gradient (mmHg) |
- |
- |
- |
| Mean gradient (mmHg) |
<25 |
25-40 |
>40 |
| Valve area (cm2) |
>1.5 |
1.0-1.5 |
<1.0 |
| We would recommend
using the ranges in the Chambers and Rimmington book unless
advised otherwise by the BSE. |
| |
|
Systolic Function |
| Fractional shortening
(%) |
28-44 |
| Ejection fraction (%) |
60-80
(50% can be normal) |
| Stroke distance (cm) |
15-35
young, 10-25 elderly |
| End-diastolic volume
(ml) |
<166
(male), <129 (female) |
| End-systolic volume
(ml) |
<67
(male), <59 (female) |
| 4 chamber area
diastole (cm2) |
18.6-48.6 |
| 4 chamber area systole
(cm2) |
8.6-30.4 |
| |
|
|
Diastolic Function |
|
| Mitral E (m/s) |
0.4-1.0
(0.3-0.9 elderly) |
| Mitral A (m/s) |
0.2-0.6
(0.3-0.9 elderly) |
| E:A ratio |
0.7-3.1
(0.5-1.7 elderly |
| Mitral E deceleration
(ms) |
139-219
(138-282 elderly) |
| Mitral A deceleration
(ms) |
>70 |
| Isovolumic relaxation
time (IVRT) ms |
54-98
(56-124 elderly) |
| |
|
| Tissue Doppler |
Normal |
Pseudonormal |
| Lateral Ea velocity |
>Age cut off |
<Age cut off |
| Lateral E/E' |
<10 |
>10 |
| PV A velocity (cm/s) |
<35 |
>35 |
| PV A duration:
transmitral A duration |
<30 |
>30 |
| Valsalva |
No change |
E/A<1 or
â50% |