| Peak mitral velocity ≥1.9 m/s* |
|---|
| Sensitivity: 90% Specificity: 89% Comments: Also consider high flow, PPM |
| VTIPrMV/VTILVO ≥ 2.5* |
| Sensitivity: 89% Specificity: 91% Comments: Measurement errors increase in atrial fibrillation due to difficulty in matching cardiac cycles; also consider PPM |
| Mean gradient ≥ 5 mmHg* |
| Sensitivity: 90% Specificity: 70% Comments: At physiologic heart rates; also consider high flow, PPM |
| Maximal TR jet velocity > 3 m/s* |
| Sensitivity: 80% Specificity: 71% Comments: Consider residual postoperative pulmonary hypertension or other causes |
| LV stroke volume derived by 2D or 3D imaging is >30% higher than systemic stroke volume by Doppler |
| Sensitivity: Moderate sensitivity Specificity: Specific Comments: Validation lacking; significant MR is suspected when LV function is normal or hyperdynamic and VTILVO is <16 cm |
| Systolic flow convergence seen in the left ventricle toward the prosthesis |
| Sensitivity: Low sensitivity Specificity: Specific Comments: Validation lacking; technically challenging to detect readily |
PrMV, Prosthetic mitral valve.
*Data from Olmos et al. When both peak velocity and VTI ratio are elevated with a normal pressure half-time, specificity is close to 100%.