European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease).

Mitral and tricuspid are increasingly prevalent. Doppler echocardiography not only detects the presence of regurgitation but also permits to understand mechanisms of regurgitation, quantification of its severity and repercussions. The present document aims to provide standards for the assessment of mitral and tricuspid regurgitation.

[1]  J. Zamorano,et al.  European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). , 2010, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[2]  R. Bonow,et al.  The emerging role of exercise testing and stress echocardiography in valvular heart disease. , 2009, Journal of the American College of Cardiology.

[3]  Arturo Evangelista,et al.  European Association of Echocardiography recommendations for training, competence, and quality improvement in echocardiography. , 2009, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[4]  M. Enriquez-Sarano,et al.  Survival implication of left ventricular end-systolic diameter in mitral regurgitation due to flail leaflets a long-term follow-up multicenter study. , 2009, Journal of the American College of Cardiology.

[5]  R. Levine,et al.  Direct measurement of vena contracta area by real-time 3-dimensional echocardiography for assessing severity of mitral regurgitation. , 2009, The American journal of cardiology.

[6]  T. Marwick,et al.  Ischaemic mitral regurgitation: mechanisms and diagnosis , 2009, Heart.

[7]  L. Badano,et al.  Evaluation of the tricuspid valve morphology and function by transthoracic real-time three-dimensional echocardiography. , 2009, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[8]  A. Mügge,et al.  What the cardiac surgeon needs to know prior to aortic valve surgery: impact of echocardiography. , 2009, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[9]  S. Bolling,et al.  The Tricuspid Valve: Current Perspective and Evolving Management of Tricuspid Regurgitation , 2009, Circulation.

[10]  A. Shiran,et al.  Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management. , 2009, Journal of the American College of Cardiology.

[11]  Harald Becher,et al.  Contrast echocardiography: evidence-based recommendations by European Association of Echocardiography. , 2008, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[12]  J. Chambers,et al.  Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. , 2009, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[13]  M. Jahangiri,et al.  Myocardial deformation abnormalities in patients with aortic regurgitation: a strain rate imaging study. , 2009, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[14]  L. Pierard,et al.  Importance of left ventricular longitudinal function and functional reserve in patients with degenerative mitral regurgitation: assessment by two-dimensional speckle tracking. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[15]  T. Marwick,et al.  How to manage ischaemic mitral regurgitation , 2008, Heart.

[16]  N. Nanda,et al.  Live/Real Time Three‐Dimensional Transthoracic Echocardiographic Assessment of Pulmonary Regurgitation , 2008, Echocardiography.

[17]  B. Gerber,et al.  Accuracy of the flow convergence method for quantification of aortic regurgitation in patients with central versus eccentric jets. , 2008, The American journal of cardiology.

[18]  Raimund Erbel,et al.  Direct assessment of size and shape of noncircular vena contracta area in functional versus organic mitral regurgitation using real-time three-dimensional echocardiography. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[19]  J. Zamorano,et al.  European Association of Echocardiography recommendations for standardization of performance, digital storage and reporting of echocardiographic studies. , 2008, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[20]  Jose Luis Zamorano,et al.  Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). , 2008, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[21]  Giuseppe Saracino,et al.  Local Dysfunction and Asymmetrical Deformation of Mitral Annular Geometry in Ischemic Mitral Regurgitation: A Novel Computerized 3D Echocardiographic Analysis , 2008, Echocardiography.

[22]  S. Hunt,et al.  Right Ventricular Function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance, and Management of Right Ventricular Failure , 2008, Circulation.

[23]  D. Adams,et al.  The role of imaging in chronic degenerative mitral regurgitation. , 2008, JACC. Cardiovascular imaging.

[24]  Takahiro Shiota,et al.  Geometry of the proximal isovelocity surface area in mitral regurgitation by 3-dimensional color Doppler echocardiography: difference between functional mitral regurgitation and prolapse regurgitation. , 2008, American heart journal.

[25]  F. Maisano,et al.  Ischemic mitral regurgitation: mechanisms and echocardiographic classification. , 2007, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[26]  M. Enriquez-Sarano,et al.  Quantitative echocardiographic determinants of clinical outcome in asymptomatic patients with aortic regurgitation: a prospective study. , 2008, JACC. Cardiovascular imaging.

[27]  M. Jahangiri,et al.  Changes in systolic left ventricular function in isolated mitral regurgitation. A strain rate imaging study. , 2007, European heart journal.

[28]  Woo-Hyung Lee,et al.  3D geometry of a normal tricuspid annulus during systole: a comparison study with the mitral annulus using real-time 3D echocardiography. , 2007, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[29]  B. Gerber,et al.  Functional Anatomy of Aortic Regurgitation: Accuracy, Prediction of Surgical Repairability, and Outcome Implications of Transesophageal Echocardiography , 2007, Circulation.

[30]  B. Popescu,et al.  Left atrial remodelling early after mitral valve repair for degenerative mitral regurgitation , 2007, Heart.

[31]  D. Kang,et al.  Three-dimensional characteristics of functional mitral regurgitation in patients with severe left ventricular dysfunction: a real-time three-dimensional colour Doppler echocardiography study , 2007, Heart.

[32]  M. Enriquez-Sarano,et al.  Left atrial remodelling in mitral regurgitation--methodologic approach, physiological determinants, and outcome implications: a prospective quantitative Doppler-echocardiographic and electron beam-computed tomographic study. , 2007, European heart journal.

[33]  F. Dini,et al.  Right ventricular dysfunction is a major predictor of outcome in patients with moderate to severe mitral regurgitation and left ventricular dysfunction. , 2007, American heart journal.

[34]  T. Marwick,et al.  Assessment of subclinical left ventricular dysfunction in asymptomatic mitral regurgitation. , 2007, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[35]  L. Pierard,et al.  Stress testing in valve disease , 2007, Heart.

[36]  Helmut Baumgartner,et al.  Guidelines on the management of valvular heart disease The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology , 2007 .

[37]  Oben Baysan,et al.  Quantification of Tricuspid Regurgitation by Live Three‐Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area , 2006, Echocardiography.

[38]  James D. Thomas,et al.  Echocardiographic predictors of successful versus unsuccessful mitral valve repair in ischemic mitral regurgitation. , 2006, The American journal of cardiology.

[39]  Young‐Bae Park,et al.  Determinants of the severity of functional tricuspid regurgitation. , 2006, The American journal of cardiology.

[40]  Takahiro Shiota,et al.  Determinants of Recurrent or Residual Functional Tricuspid Regurgitation After Tricuspid Annuloplasty , 2006, Circulation.

[41]  Chun-Peng Liu,et al.  Severe tricuspid regurgitation shows significant impact in the relationship among peak systolic tricuspid annular velocity, tricuspid annular plane systolic excursion, and right ventricular ejection fraction. , 2006, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[42]  K. Iwakura,et al.  Comparison of orifice area by transthoracic three-dimensional Doppler echocardiography versus proximal isovelocity surface area (PISA) method for assessment of mitral regurgitation. , 2006, The American journal of cardiology.

[43]  William Stewart,et al.  Recommendations for chamber quantification. , 2006, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[44]  N. Nanda,et al.  Assessment of Aortic Regurgitation by Live Three‐Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area: Usefulness and Validation , 2005, Echocardiography.

[45]  C. Duran,et al.  Progression of Tricuspid Regurgitation After Repaired Functional Ischemic Mitral Regurgitation , 2005, Circulation.

[46]  L. Pierard,et al.  Long-term outcome of patients with heart failure and dynamic functional mitral regurgitation. , 2005, European heart journal.

[47]  J. Després,et al.  Our passive lifestyle, our toxic diet, and the atherogenic/diabetogenic metabolic syndrome: can we afford to be sedentary and unfit? , 2005, Circulation.

[48]  J. Garot,et al.  Functional assessment of mitral regurgitation by transthoracic echocardiography using standardized imaging planes diagnostic accuracy and outcome implications. , 2005, Journal of the American College of Cardiology.

[49]  M. Enriquez-Sarano,et al.  Quantitative determinants of the outcome of asymptomatic mitral regurgitation. , 2005, The New England journal of medicine.

[50]  P. Kilner,et al.  Pulmonary regurgitation: not a benign lesion. , 2005, European heart journal.

[51]  R. Schnabel,et al.  Assessment of the Tricuspid Valve Morphology by Transthoracic Real‐Time‐3D‐Echocardiography , 2005, Echocardiography.

[52]  N. Nanda,et al.  Quantification of Mitral Regurgitation by Live Three‐Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area , 2004, Echocardiography.

[53]  L. Pierard,et al.  The role of ischemic mitral regurgitation in the pathogenesis of acute pulmonary edema. , 2004, The New England journal of medicine.

[54]  M. Enriquez-Sarano,et al.  Medical and surgical outcome of tricuspid regurgitation caused by flail leaflets. , 2004, The Journal of thoracic and cardiovascular surgery.

[55]  S. Ray,et al.  Three-dimensional echocardiography is superior to multiplane transoesophageal echo in the assessment of regurgitant mitral valve morphology. , 2004, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[56]  O. Alfieri,et al.  Pulsed tissue Doppler imaging detects early myocardial dysfunction in asymptomatic patients with severe mitral regurgitation , 2004, Heart.

[57]  L. Pierard,et al.  Determinants of exercise-induced changes in mitral regurgitation in patients with coronary artery disease and left ventricular dysfunction. , 2003, Journal of the American College of Cardiology.

[58]  L. Pierard,et al.  Prognostic Importance of Exercise-Induced Changes in Mitral Regurgitation in Patients With Chronic Ischemic Left Ventricular Dysfunction , 2003, Circulation.

[59]  P. Grayburn,et al.  Color flow imaging of the vena contracta in mitral regurgitation: technical considerations. , 2003, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[60]  R. Levine,et al.  Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. , 2003, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[61]  T. Rea,et al.  A Community-Based Study , 2004 .

[62]  N. Espinola-Zavaleta,et al.  Anatomic three-dimensional echocardiographic correlation of bicuspid aortic valve. , 2003, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[63]  M. Enriquez-Sarano,et al.  Contrasting effect of similar effective regurgitant orifice area in mitral and tricuspid regurgitation: a quantitative Doppler echocardiographic study. , 2002, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[64]  S. Siu,et al.  Intraoperative transesophageal echocardiography accurately predicts mitral valve anatomy and suitability for repair. , 2002, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[65]  E. Schwammenthal,et al.  Mechanism of mitral regurgitation in inferior wall acute myocardial infarction. , 2002, The American journal of cardiology.

[66]  M. Eren,et al.  Determination of vena contracta and its value in evaluating severity of aortic regurgitation. , 2002, The Journal of heart valve disease.

[67]  Richard V. Williams,et al.  Comparison of Doppler echocardiography with angiography for determining the severity of pulmonary regurgitation. , 2002, The American journal of cardiology.

[68]  Quantitation of functional mitral regurgitation during bicycle exercise in patients with heart failure. , 2001, Journal of the American College of Cardiology.

[69]  A. Fraser,et al.  Assessment of left ventricular long axis contraction can detect early myocardial dysfunction in asymptomatic patients with severe aortic regurgitation , 2001, Heart.

[70]  T. Marwick,et al.  Exercise echocardiography predicts development of left ventricular dysfunction in medically and surgically treated patients with asymptomatic severe aortic regurgitation , 2000, Heart.

[71]  M. Enriquez-Sarano,et al.  Quantification of tricuspid regurgitation by measuring the width of the vena contracta with Doppler color flow imaging: a clinical study. , 2000, Journal of the American College of Cardiology.

[72]  M. Enriquez-Sarano,et al.  Assessment of severity of aortic regurgitation using the width of the vena contracta: A clinical color Doppler imaging study. , 2000, Circulation.

[73]  R. Davidoff,et al.  Aortic Regurgitation: Quantitative Methods by Echocardiography , 2000, Echocardiography.

[74]  A J Tajik,et al.  Progression of mitral regurgitation: a prospective Doppler echocardiographic study. , 1999, Journal of the American College of Cardiology.

[75]  M. Enriquez-Sarano,et al.  Determinants of pulmonary venous flow reversal in mitral regurgitation and its usefulness in determining the severity of regurgitation. , 1999, The American journal of cardiology.

[76]  R. Nishimura,et al.  A simplified, practical approach to assessment of severity of mitral regurgitation by Doppler color flow imaging with proximal convergence: validation with concomitant cardiac catheterization. , 1998, Mayo Clinic proceedings.

[77]  M. Enriquez-Sarano,et al.  Application of the proximal flow convergence method to calculate the effective regurgitant orifice area in aortic regurgitation. , 1998, Journal of the American College of Cardiology.

[78]  W. Koenig,et al.  Comparison of the proximal flow convergence method and the jet area method for the assessment of the severity of tricuspid regurgitation. , 1998, European heart journal.

[79]  P. Grayburn,et al.  Comparison of vena contracta width by multiplane transesophageal echocardiography with quantitative Doppler assessment of mitral regurgitation. , 1998, The American journal of cardiology.

[80]  M. Enriquez-Sarano,et al.  Grading of mitral regurgitation by quantitative Doppler echocardiography: calibration by left ventricular angiography in routine clinical practice. , 1997, Circulation.

[81]  P. Grayburn,et al.  Assessment of mitral regurgitation severity by Doppler color flow mapping of the vena contracta. , 1997, Circulation.

[82]  D. Mele,et al.  Value of proximal regurgitant jet size in tricuspid regurgitation. , 1996, American heart journal.

[83]  S. Nagueh,et al.  Relation of mean right atrial pressure to echocardiographic and Doppler parameters of right atrial and right ventricular function. , 1996, Circulation.

[84]  W. Shen,et al.  Comparative value of Doppler echocardiography and cardiac catheterization for management decision-making in patients with left-sided valvular regurgitation. , 1996, European heart journal.

[85]  J. Roelandt,et al.  Multiplane transoesophageal echocardiography and morphology of regurgitant mitral valves in surgical repair. , 1995, European heart journal.

[86]  M. Enriquez-Sarano,et al.  Effective mitral regurgitant orifice area: clinical use and pitfalls of the proximal isovelocity surface area method. , 1995, Journal of the American College of Cardiology.

[87]  Y. Ko,et al.  Reappraisal of quantitative evaluation of pulmonary regurgitation and estimation of pulmonary artery pressure by continuous wave Doppler echocardiography. , 1995, Cardiology.

[88]  M. Enriquez-Sarano,et al.  Overestimation of severity of ischemic/functional mitral regurgitation by color Doppler jet area. , 1994, The American journal of cardiology.

[89]  W. Shen,et al.  Mitral to aortic velocity-time integral ratio , 1994 .

[90]  J. A. Vázquez de Prada,et al.  Assessment of tricuspid regurgitation by Doppler color flow imaging: angiographic correlation. , 1994, International journal of cardiology.

[91]  M. Enriquez-Sarano,et al.  Effective regurgitant orifice area: a noninvasive Doppler development of an old hemodynamic concept. , 1994, Journal of the American College of Cardiology.

[92]  B Lüderitz,et al.  Color-coded Doppler imaging of the vena contracta as a basis for quantification of pure mitral regurgitation. , 1994, The American journal of cardiology.

[93]  W. Shen,et al.  Mitral to aortic velocity-time integral ratio. A non-geometric pulsed-Doppler regurgitant index in isolated pure mitral regurgitation. , 1994, European heart journal.

[94]  M. Enriquez-Sarano,et al.  Color flow imaging compared with quantitative Doppler assessment of severity of mitral regurgitation: influence of eccentricity of jet and mechanism of regurgitation. , 1993, Journal of the American College of Cardiology.

[95]  James B. Seward,et al.  Quantitative Doppler Assessment of Valvular Regurgitation , 1993, Circulation.

[96]  J L Rey,et al.  Assessment of severity of mitral regurgitation by measuring regurgitant jet width at its origin with transesophageal Doppler color flow imaging. , 1992, Circulation.

[97]  A. Weyman,et al.  The effects of regurgitant orifice size, chamber compliance, and systemic vascular resistance on aortic regurgitant velocity slope and pressure half-time. , 1991, American heart journal.

[98]  A. Weyman,et al.  Impact of Impinging Wall Jet on Color Doppler Quantification of Mitral Regurgitation , 1991, Circulation.

[99]  W. Shen,et al.  End diastolic flow velocity just beneath the aortic isthmus assessed by pulsed Doppler echocardiography: a new predictor of the aortic regurgitant fraction. , 1991, British heart journal.

[100]  S. Rahimtoola,et al.  Significance of laminar systolic regurgitant flow in patients with tricuspid regurgitation: a combined pulsed-wave, continuous-wave Doppler and two-dimensional echocardiographic study. , 1990, American heart journal.

[101]  S. Nakano,et al.  Quantitative evaluation of pulmonary regurgitation after repair of tetralogy of Fallot using real-time flow imaging system. , 1989, Japanese circulation journal.

[102]  L. Hatle,et al.  Half time of the diastolic aortoventricular pressure difference by continuous wave Doppler ultrasound: a measure of the severity of aortic regurgitation? , 1989, British heart journal.

[103]  A. Weyman,et al.  Prevalence of valvular regurgitation by Doppler echocardiography in patients with structurally normal hearts by two-dimensional echocardiography. , 1989, American heart journal.

[104]  G. Marx,et al.  Noninvasive assessment of hemodynamic responses to exercise in pulmonary regurgitation after operations to correct pulmonary outflow obstruction. , 1988, The American journal of cardiology.

[105]  N C Nanda,et al.  Evaluation of aortic insufficiency by Doppler color flow mapping. , 1987, Journal of the American College of Cardiology.

[106]  S. Goldberg,et al.  Quantitative assessment by Doppler echocardiography of pulmonary or aortic regurgitation. , 1985, The American journal of cardiology.

[107]  Youshouzhai Gu.  Echo , 1980, The Craft of Poetry.

[108]  A Piwnica,et al.  Reconstructive surgery of mitral valve incompetence: ten-year appraisal. , 1980, The Journal of thoracic and cardiovascular surgery.