Assessment of the severity of chronic aortic regurgitation by echocardiography

TTE: transthoracic echocardiogram; AR: aortic regurgitation; TEE: transesophageal echocardiogram; CMR: cardiovascular magnetic resonance imaging; RVol: regurgitant volume; RF: regurgitant fraction; EROA: effective regurgitant orifice area; VC: vena contracta; LVOT: left ventricular outflow tract; PHT: pressure half-time; CWD: continuous wave Doppler; LV: left ventricle.
* Beware of limitations of color Doppler assessment of jet width in patients with eccentric jets.
¶ For patients with four or more specific criteria for severe AR, the use of detailed quantitative parameters is optional.
Δ Low confidence in TTE assessment of AR (specific criteria plus detailed quantitative methods) may be caused by suboptimal technical quality or presence of an unexpected degree of discordance between specific criteria, quantitative parameters, and/or clinical assessment.
◊ Since use of detailed quantitative parameters is subject to limitations and can be technically challenging, quantitative assessment is based upon which parameter(s) is appropriate and technically feasible in each study. For example, for EROA, feasibility is limited by aortic calcifications, and this method is not valid for multiple jets and is less accurate for eccentric jets.