Pulmonic regurgitation Doppler echocardiography
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Pulse wave Doppler echocardiography
Pulse wave Doppler echocardiography has diagnostic limitations. Upon examination, as many as 87% of normal patients may appear to have pulmonic regurgitation. Length and duration of the regurgitant jet must be calculated to differentiate between true and physiologic pulmonic regurgitation. In physiologic pulmonic regurgitation the jet is < 1 cm in length and no holodiastolic in duration. The severity of pulmonic regurgitation should be further assessed via mapping techniques.
CW Doppler echocardiography
In this analysis, a comparison is made between the regurgitant Doppler spectral display and the pulmonic outflow Doppler spectral display. The pulmonary artery end-diastolic pressure is assessed as well.
Color Flow Doppler echocardiography
In this analysis, the length and width of the pulmonic regurgitation is assessed. If there is a pattern of proximal acceleration (flow convergence), this is consistent with 3+ or 4+ pulmonic regurgitation.
Pulmonary Insufficiency Severity Scales
PW and Color flow Doppler
- Physiologic : < 1 cm in length and not holodiastolic in duration
- Borderline : 1 to 2 cm in length and holodiastolic in duration
- Clinically significant : > 2 cm in length with a peak velocity > 1. 5 m/sec and holodiastolic in duration
CW Doppler Spectral Strength of Regurgitant Jet
- Grade 1+ : Spectral tracing stains sufficiently for detection, but not enough for clear delineation
- Grade 2+ : Complete spectral tracing can just be seen
- Grade 3+ : Distinct darkening of spectral tracing is visible but density is less than antegrade flow
- Grade 4+ : Dark-stained spectral tracing