27
Valve Hemodynamics
a
Associated Cardiac
Findings Symptoms
• No MR jet or small central jet
area <20% left atrium (LA)
on Doppler
• Small vena contracta
<0.30 cm
• Normal or mildly dilated
LV size with fixed
(infarction) or inducible
(ischemia) regional wall
motion abnormalities
• Primary myocardial
disease with LV dilation
and systolic dysfunction
• Symptoms due to
coronary ischemia
or HF may be
present that respond
to revascularization
and appropriate
medical therapy
• ERO <0.40 cm
2
b
• Regurgitant volume <60 mL
• Regurgitant fraction <50%
• Regional wall motion
abnormalities with
reduced LV systolic
function
• LV dilation and systolic
dysfunction due to
primary myocardial
disease
• Symptoms due to
coronary ischemia
or HF may be
present that respond
to revascularization
and appropriate
medical therapy
• ERO ≥0.40 cm
2
b
• Regurgitant volume ≥60 mL
• Regurgitant fraction ≥50%
• Regional wall motion
abnormalities with
reduced LV systolic
function
• LV dilation and systolic
dysfunction due to
primary myocardial
disease
• Symptoms due to
coronary ischemia
or HF may be
present that respond
to revascularization
and appropriate
medical therapy
• ERO ≥0.40 cm
2
b
• Regurgitant volume ≥60 mL
• Regurgitant fraction ≥50%
• Regional wall motion
abnormalities with
reduced LV systolic
function
• LV dilation and systolic
dysfunction due to
primary myocardial
disease
• HF symptoms
due to MR
persist even after
revascularization
and optimization of
medical therapy
• Decreased exercise
tolerance
• Exertional dyspnea
