Table 4 Guideline based reference ranges for grading mr 2014 AHA/ACC Guidelines
From: Echocardiographic assessment of ischemic mitral regurgitation
2014 AHA/ACC Guidelines | ||||
|---|---|---|---|---|
Parameter | Stage A “At risk” | Stage B “Progressive” | Stage C “Asymptomatic Severe” | Stage D “Symptomatic Severe” |
Valve apparatus and anatomy | CAD or cardiomyopathy, with normal valve leaflets, chords, annulus | Regional WMA with mild tethering of MV | Regional WMA ± LV dilatation with severe tethering of MV | Regional WMA ± LV dilatation with severe tethering of MV |
Annular dilatation with mild loss of central coaptation | Annular dilatation with severe loss of central coaptation | Annular dilatation with severe loss of central coaptation | ||
LV (ischemic or primary myocardial disease) | No or mild dilatation with infarct or inducible ischemia, or cardiomyopathy with LV systolic dysfunction and dilatation | Regional WMA with reduced LV systolic function ± dilatation | Regional WMA with reduced LV systolic function ± dilatation | Regional WMA with reduced LV systolic function ± dilatation |
Symptoms | May be present, may respond to GDMT | May be present, may respond to GDMT | May be present, may respond to GDMT | Symptoms persist despite GDMT |
EROA-CIMR (cm 2 ) | < 0.2 | < 0.2 | ≥ 0.2 | ≥ 0.2 |
Jet/LA area | No MR jet or jet area/LA area <20% | 20-39% | ≥ 40% | ≥ 40% |
VC width (cm) | < 0.3 | ≥ 0.7 | ≥ 0.7 | |
Regurgitant Fraction | < 50% | ≥ 50% | ≥ 50% | |
Regurgitant Volume | < 30 mL | ≥ 30 mL | ≥ 30 mL | |