Structural parameters
LA size
Mild:Normal(1)
Moderate:Normal or dilated
Severe:Usually dilated(2)
Aortic leaflets
Mild:Normal or abnormal
Moderate:Normal or abnormal
Severe:Abnormal/flail, or wide coaptation defect
Doppler parameters
Jet width in LVOT –Color Flow(3)
Mild:Small in central jets
Moderate:Intermediate
Severe:Large in central jets; variable in eccentric jets
Jet density–CW
Mild:Incomplete or faint
Moderate:Dense
Severe:Dense
Jet deceleration rate –CW (PHT, ms)(4)
Mild:Slow >500
Moderate:Medium 500-200
Severe:Steep <200
Diastolic flow reversal in descending aorta –PW
Mild:Brief, early diastolic reversal
Moderate:Intermediate
Severe:Prominent holodiastolic reversal
Quantitative parameters(5)
VC width (cm)(3)
Mild:<0.3
Moderate:0.3-0.60
Severe:>0.6
Jet width/LVOT width (%)(3)
Mild:<25
Mild-Moderate:25-45
Moderate-Severe:46-64
Severe:≥65
Jet CSA/LVOT CSA (%)(3)
Mild:<5
Mild-Moderate:5-20
Moderate-Severe:21-59
Severe:≥60
R Vol (mL/beat)
Mild:<30
Mild-Moderate:30-44
Moderate-Severe:45-59
Severe:≥60
RF (%)
Mild:<30
Mild-Moderate:30-39
Moderate-Severe:40-49
Severe:≥50
EROA (cm2)
Mild:<0.10
Mild-Moderate:0.10-0.19
Moderate-Severe:0.20-0.29
Severe:≥0.30

AR, Aortic regurgitation; CSA, cross sectinal area; CW, continuous wave Doppler; EROA, effective regurgitant orifice area; LV, left ventricle; LVOT, left ventricular outflow tract; PHT, pressure half-time; PW, pulsed wave Doppler; R Vol, regurgitant volume; RF, regurgitant fraction; VC, vena contracta.

  1. Unless there are other reasons for LV dilation. Normal 2D measurements: LV minor axis ≤2.8 cm/m2, LV end-diastolic volume ≤82 mL/m2 (2).
  2. Exception: would be acute AR, in which chambers have not had time to dilate.
  3. At a Nyquist limit of 50–60 cm/s.
  4. PHT is shortened with increasing LV diastolic pressure and vasodilator therapy, and may be lengthened in chronic adaptation to severe AR
  5. Quantitative parameters can sub-classify the moderate regurgitation group into mild-to-moderate and moderate-to-severe regurgitation as shown.