Right ventricle, pulmonary artery, pulmonary artery pressure
Right ventricle and pulmonary artery Normal interval Mildly abnormal Moderately abnormal Severely abnormal RV DIMENSIONS Basal RV diameter (RVD 1), cm 2.0–2.8 2.9–3.3 3.4–3.8 3.9…
Right ventricle and pulmonary artery
| Normal interval | Mildly abnormal | Moderately abnormal | Severely abnormal | |
| 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 |
Tricuspid valve
Tricuspid valve regurgitation
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 |
References
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
Tricuspid valve stenosis
| 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 |
References
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.
Pulmonary valve
Pulmonary valve regurgitation
| 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 |
References
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.
3. 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.
Pulmonary valve stenosis
| Mild stenosis | Moderate stenosis | Severe stenosis | |
| Peak velocity (m/s) | < 3 | 43528 | > 4 |
| Peak gradient (mmHg) | < 36 | 36-64 | > 64 |
References
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.
Pulmonary valve
Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW-Doppler weak,…
QT Drugs: Drugs causing QT prolongation, torsade de pointes (TdP) and long QT syndrome (LQTS)
A comprehensive list of conditions and drugs that may prolong the QT interval, and cause torsade de pointes (TdP) and long QT syndrome (LQTS) is presented below. With regards to…